多普勒组织成像对显性预激综合征的旁道定位

Location of the pre-excitation part in Wolff-Parkinson-White syndrome by Doppler tissue imaging

为评价多普勒组织成像 (DTI)对定位标测显性预激综合征旁道的可行性和准确性 ,用DTI的加速度方式检查 3 3例显性预激综合征患者、5例起搏器安装者及 1 0例正常人的心肌收缩顺序 ,并将DTI所观察到的预激患者的心室壁提前收缩部位与射频消融术中心内电生理检查标测的“靶点”比较。结果显示 :①预激组左侧显性旁道 2 1例 ,准确定位 1 8例 (准确率 85 .7% ) ,右侧显性旁道 1 2例 ,准确定位 8例 (准确率 6 6 .7% ) ,两侧定位准确率差异无显著性 (P >0 .0 5 )。定位总准确率为 78.8%。②起搏组中起博电极处右室心肌最早收缩。③正常组心室激动顺序为间隔心底段、游离壁及心尖部。上述结果表明DTI的加速度方式可用于检测心室正常或异常的除极过程 。

Objective To evaluate the feasibility of newly developed Doppler tissue imaging ( DTI ) for locating the early contraction sites in Wolff Parkinson White ( WPW ) syndrome. Methods The time sequential changes in ventricular wall motion of thirty three patients suffering from WPW syndrome were examined by DTI.The pre excitation site was represented as a red region appearing on the myocardium right after the δ wave of the electrocardiogram and confirmed by electrophysiology. Result Of 21 patients with left sided accessory pathways,the early contractive sites were correctly identified by DTI in 18 patients, while the sites were determined by DTI in 8 of 12 patients with right sided accessory pathways.There was no significant difference between the two groups (P>0.05). Conclusion The DTI system is helpful to localize the accessory pathways and evaluate the results after radiofrequency ablation.