单声窗多切面法估测圆锥动脉干畸形术后右心室长轴应变的研究

Multiple-view assessment of right ventricular longitudinal strain in children after repair of conotruncal defects from one acoustic window

目的探讨斑点追踪技术(STI)单声窗多切面法无创评估儿童圆锥动脉干畸形(CTD)术后右心室功能的可行性和准确性。方法采用STI单声窗多切面法估测31例CTD双心室修补术后患儿与31例年龄、性别匹配的健康正常儿童的右心室游离壁收缩期达峰长轴应变(RVLS)。并将各切面的RVLS与心脏磁共振(CMR)的右心室射血分数(RVEF)进行相关性分析。结果对比正常对照组,病例组右心室前壁、侧壁、下壁a(位于同时显示主动脉的切面)、下壁b(位于冠状切面)的RVLS均降低(P <0. 001)。右心室前壁、侧壁、下壁a、下壁b的RVLS与CMR-RVEF相关性好,其中下壁a的RVLS与CMR-RVEF相关性最好(r=-0. 801,P <0. 001)。结论 STI单声窗多切面法能无创、准确地评估CTD术后患儿的右心室功能。

Objective To explore the feasibility- and accuracy of nmltiple-view analyses of right ventricular functionof children who underwent biventricular repair of a conotruncal defect （CTD） from one acoustic window by speckle tracking imaging （STI）. Methods Thirty-one children with repaired CTD and 31 age, gender-matched healthy children （controls） were enrolled and the peak systolic right ventricular longitudinal strain （RVLS） of the free-walls were measured in the multiple-view way from one acoustic window by STI. The correlations between multiple-view RVLS and RVEF using cardiac magnetic resonance （CMR） were analysed. Results Compared with healthy controls, RVLS of the anterior, lateral, inferiora and inferiorb walls were all significantly reduced in children after repair of CTD （ P 〈 0. 001 ）. RVLS of the anterior, lateral, inferior （in the aortic view） and inferiorb （in the coronal view） walls was correlated well with CMR-RVEF. The correlation between RVLS of the inferior walla and CMR-RVEF was the best （ r = -0. 801, P 〈 0. 001 ）. Conclusion Multiple-view assessment of RVLS from one acoustic window by STI is a noninvasive and accurate way to interpret the right ventricular function in children after repair of CTD.