二维斑点追踪技术及直接二维测量法评价正常人心肌生物力学参数结果比较

Application of speckle tracking technology and direct two-dimensional measurement in evaluating the normal myocardial biomechanical parameters

目的:探讨直接二维测量法(D2D)评价心肌应变及心功能的可行性。方法:分别应用D2D及二维斑点追踪技术(STI)测量60名正常人收缩期纵向应变(LS)及圆周应变(CS),比较两种方法测量的结果。结果:STI及D2D都表现为收缩期LS绝对值从基底段到心尖段逐步递增,CS基底段到心尖段逐步递减;STI及D2D测量结果心肌收缩期LS绝对值及CS绝对值与左心室射血分数(LVEF)即LS-LVEF和CS-LVEF均呈正相关,STI测量LS-LVEF、CS-LVEF的r分别是0.693和0.561,P<0.05;D2D测量LS-LVEF和CS-LVEF的r分别是0.589和0.457,P<0.05;D2D与STI两种方法 LS-LVEF r和CS-LVEF r差异无统计学意义,D2D不能分开心室各室壁CS,仅能通过测量整体收缩舒张期心内外膜周长变化间接计算整体CS,测量结果绝对值高于STI测量结果。D2D法检测室壁LS为下壁>后间隔>前间隔>后壁>前壁>侧壁,但差异无统计学意义(P>0.05);STI法各室壁LS为下壁>侧壁>前间隔>后壁>后间隔>前壁,但差异无统计学意义(P>0.05)。STI及D2D检测结果心内膜层心肌CS均高于心外膜层心肌(P<0.05),二尖瓣水平显著高于乳头肌及心尖段水平(P<0.05),D2D法测量结果绝对值高于STI法,但D2D法及STI法测量的LS-LVEF和CS-LVEF差异无统计学意义(P>0.05),说明D2D法测量代替STI法检测心肌应变方法可行,结果接近。结论:D2D测量结果与STI相关性高,代替STI法有一定的可行性和准确性,适用于仅有普通设备的基层医院。

Objective:To explore the feasibility of direct two dimensional(D2D)measurement in evaluating the myocardial strain and cardiac function.Methods:The systolic longitudinal strain(LS)and circumferential strain(CS)in60normal people were measured using the D2D and STI,respectively.The result between STI and D2D was compared.Results:The absolute value of LS and CS detected by STI and D2D gradually increased and decreased from the basal segment to the apical segment,respectively.The absolute value of LS and CS detected by STI and D2D were positive correlation with LS LVEF and CS LVEF.The correlation coefficients of LS LVEF and CS LVEF detected by STI were0.693and0.561,respectively,the correlation coefficients of LS LVEF and CS LVEF detected by D2D were0.589and0.457,respectively,and the differences of the correlation coefficients of LS LVEF and CS LVEF detected by two methods were not statistically significant(P>0.05).D2D could not separate the CS of ventricular walls,which could indirectly accounted by measuring the circumference changes of systolic diastolic heart inner and outer membrane.The absolute value of the measurement results of D2D was higher than that of STI.The LS detected by D2D in infereior wall,posterior septum,anterior septum,posterior wall,anterior wall and laterior wall gradually decreased,and the differences of whose were not statistically significant(P>0.05).The LS detected by STI in infereior wall,laterior wall,anterior septum,posterior wall,posterior septum and anterior wall gradually decreased,and the differences of whose were not statistically significant(P>0.05).The results of STI and D2D methods showed that the endocardial myocardial layers CS was higher than that in the epicardial layer(P<0.05),and the level of mitral valve was significantly higher than that of papillary muscle and apical segment(P<0.05).The absolute value of D2D method was higher than that of STI method(P<0.05),but there was not significantly different in LS LVEF and CS LVEF between STI and D2D methods,which indicated that the D2D method instead of STI method was feasible in detecting myocardial strain,and the results of STI and D2D methods were close.Conclusions:The correlation of D2D results with result of STI method is high.The STI method has certain feasibility and accuracy,which is suitable for primary hospital with ordinary equipment.