256层CT评估中青年国人正常左心室局部功能

Left ventricular regional function in healthy young and middle-aged Chinese evaluated by 256-slice computed tomography

目的确立正常中青年国人左心室局部功能参数256层CT正常值,并探讨左心室局部功能参数16肌段正常值的规律。方法 128例正常中青年国人行256层CT心脏冠脉CTA及心功能检查,飞利浦智能高级后处理工作站按16肌段法测量局部功能参数收缩期室壁厚度(ESWT)、舒张期室壁厚度(EDWT)、室壁运动(WM)、室壁增厚率(WT%),并进行统计学分析。结果 (1)测得256层CT左心室局部功能参数正常值范围。(2)依据左心室室壁各个肌段之间的解剖学毗邻关系,整合16肌段数据,分析发现:左心室游离壁:从心尖部到基底部EDWT和WM逐渐增大;ESWT乳头肌部最大、基底部次之,心尖部最小;WT乳头肌部最大,心尖部次之,基底部最小。左心室室间隔:EDWT、ESWT、WM均为乳头肌部最大、心尖部次之,基底部部最小;WT从心尖部到基底部依次减小。左心室游离壁和室间隔比较:各肌部、各参数值前者均较大。(3)圆周方向分布特点:依照前段、前隔段、下隔段、下段、下侧段、前侧段的顺序,EDWT、ESWT、WT%、WM在平滑线散点图上均呈近似正"V"形分布。(4)径向分布特点:从心尖部、乳头肌部到基底部,EDWT、ESWT、WT%、WM在带平滑线的散点图上均呈近似倒"V"形分布。结论获得正常中青年国人256层CT左心室局部功能参数正常值,且16肌段参数存在一定规律。

Objective To establish the normal range of left ventricular （ LV） regional function parameters in healthy young and middle-aged Chinese by using 256-slice CT, and to explore the change rule of normal value of left ventricular regional function parameters in 16 segments.Methods One hundred and twenty-eight healthy young and middle-aged Chinese underwent 256-slice CT angiography and cardiac functional analysis .The dedicated software of the Extended Brilliance Workspace （ Philips Medical Systems ） was used to calculate the end-systole wall thickness （ ESWT ） , end-diastole wall thickness（EDWT）,wall motion（WM） and wall thickening percent according to 16 segments measurement method .Finally the results were statistically analyzed.Results （1）The normal range of left ventricular （LV） regional function parameters in healthy young and middle-aged people was obtained by 256-slice CT.（2）Based on the anatomy of left ventricular wall ,the 16 segments were divided into two parts：the left ventricular free wall and the interventricular septum .EDWT and WM were increased gradually from apex to base;EDWT,ESWT,WM were the largest in papillary muscle ,the next in apex of heart ,the smallest in basilar part , however , WT was gradually decreased from apex of heart to basilar part .These values in free left ventricularwall were greater than those in interventricular septum .（ 3 ） The distribution characteristics in circumferential direction：according to the order of anterior ,antero-septal,infero-septal,inferior,posterior,ventri segment,the EDWT,ESWT, WT percent, and WM showed the distribution of “V” shape on the scattergram approximately .（ 4 ） The distribution characteristics in longitudinal directions：from apex of heart to basilar part ,the EDWT,ESWT,WT percent and WM showed the distribution of inverted “V” shape on the scattergram approximately .Conclusoin The normal range of LV regional function parameters in healthy young and middle-aged Chinese is established by 256-slice CT, and there is certain rule in the parameters of 16 segments .