斑点追踪成像技术评估室间隔缺损患儿左室扭转运动的初步研究

Preliminary clinical reseach of the left ventricular twist and rotation in children with ventricular septal defect by speckle tracking imaging

目的探讨斑点追踪成像(STI)技术在评估室间隔缺损(VSD)患儿左室扭转运动中的临床价值。方法随机选取VSD患儿36例(VSD组)和无心脏疾病的健康儿童36例(正常对照组),应用实时三维超声测量左室射血分数;STI技术测量并记录两组左室扭转运动参数,并对其结果进行对比分析。采用Pearson相关分析法分析左室扭转运动参数与左室舒张末期容积及左室舒张末期容积指数的相关性。结果 VSD组左室基底部旋转角度、左室基底部旋转角度峰值、左室扭转角度及扭力均明显大于正常对照组,差异均有统计学意义(均P<0.01),心尖部旋转角度及心尖部旋转角度峰值差异均无统计学意义(P=0.525、0.757)。左室扭转运动参数与左室舒张末期容积、左室舒张末期容积指数及左室射血分数均无相关性。结论 STI可较为准确地分析并评估VSD患儿左室节段及整体扭转运动;左室扭转运动参数较敏感地反映了左室心肌代偿性运动增强的存在。

Objective To evaluate the clinical value of speckle tracking imaging（STI） in evaluating the left ventricular twist and rotation in children with ventricular septal defect （VSD）. Methods Childrdn with ventricular septal defect （36 cases ） as the case group, age and sex matched normal children（36 cases） as the control group,left ventricular ejection fraction were obtained by real-time three-dimensional eehocardiography,STI was used to measure the left ventricular twist and rotation parameters of two groups, the results was compared and analyzed. The correlation between left ventricular twist and rotation parameters and left ventricular and diastolic volume and its index, and ejection fraction were analyzed by Pearson correlation analysis, Results In the VSD group, the left ventricular basal rotation angle, peak of the left ventricular basal rotation angle, peak of the left ventricular twist angle and torsion were significantly greater than those in the control group（ all P〈0.01 ）, while the apical rotation and peak of the apical rotation angle had no statistical significance compared with the control group （P =0.525,0.757 ）.There was no significant correlation between left ventricular twist and rotation parameters,and left ventricular diastolic volume and its index,and ejection fraction. Conclusion STI can be used to analyze the left ventricular segemental and global twist and rotation accurately, and the compensatory of left ventricular myocardium can be reflected by left ventricular twist and rotation parameters sensitively.