斑点追踪成像技术对冠心病患者长轴节段性室壁运动异常的评价

Speckle tracking imaging studies in patients with coronary heart disease to the long axis of the segmental wall motion abnormalities

目的 :探讨斑点追踪成像技术(speckle tracking imaging,STI)评价长轴左室节段性室壁运动异常的临床价值。方法 :采用STI技术检测41例健康人及29例冠心病患者心尖四腔切面、两腔切面及三腔切面18节段的STI纵向峰值应变(LS),并与冠状动脉造影异常供血室壁节段结果及M型超声心动图检测室壁运动结果比较。结果:冠心病患者左室壁运动异常节段STI表现为LS的明显降低,18节段LS均较对照组减低(P<0.01);冠心病组M型超声心动图表现为室壁运动幅度减低或消失,室壁增厚率减低或消失,18节段室壁运动幅度均较对照组减低(P<0.01)。STI对冠心病的阳性检出率为87.3%(269/308),M型超声心动图对冠心病的阳性检出率为63.3%(195/308),二者差异有统计学意义(P<0.05)。结论:STI技术能够早期、无创、快速、客观地定量和定性分析左室壁节段性运动异常,明显提高节段性室壁运动异常的检出率。

Objective：Study of speckle tracking imaging （STI） to evaluate the clinical value of the long axis of left ventricular segmental wall motion abnormalities. Methods：Forty-one healthy subjects and 29 patients with coronary heart disease were ex-amined by STI technology. Apical four chamber view,two chamber view and three chamber view of left ventricle were detected in 18 segments of the STI peak longitudinal strain LS. And the results were compared with abnormal feeding segmental ven-tricular wall of coronary angiography and M-type ultrasonic heartbeat diagram to detect wall motion amplitude results. Results：Left ventricular wall motion abnormalities segment of patients with coronary heart disease showed peak LS obviously reduced by STI. M-type ultrasonic heartbeat diagram showed ventricular wall motion and wall thickening rate reduce or disappear. STI showed the coronary heart disease group of 18 segments of LS were lower than normal control group the difference was statisti-cally significant （P〈0.01）. M-type ultrasonic heartbeat graphic coronary heart disease group of 18 segmental ventricular wall motion amplitude were lower than normal control group,the difference was statistically significant （P〈0.01）. The positive detec-tion rate of coronary heart disease was 87.3% by STI,that was 63.3% by M-type ultrasonic heartbeat diagram,there was signifi-cant difference between the two methods （P〈0.05）. Conclusion：STI technology can early,non-invasively,rapidly and objectively qualitative and quantitative analyze left ventricular segmental wall motion abnormalities,it can improve the detection rate of seg-mental wall motion abnormalities obviously.