应用不依赖厂家图像的三维分析软件评估心肌梗死前后左室心肌应变的研究

Evaluation of left ventricular myocardial strain before and after myocardial infarction using a vendor-independent three-dimensional analysis software

目的:探讨应用不依赖厂家图像的三维分析软件(Tomtec)评估心肌梗死前后左室心肌应变的临床价值。方法:取10枚新鲜的猪心,连接于一个脉动泵装置,每搏量设定为30~70 ml。将超声微晶体缝合于心外膜以获取相应的心肌应变值作为应变金标准。使用GE公司超声机器获取心肌梗死前后左室全容积三维图像(5枚猪心制备心肌梗死模型),通过Tomtec分析软件获取纵向应变及圆周应变,将其与声学测微法所得心肌应变值比较,并分析相关性。结果:正常心肌及心肌梗死模型经Tomtec软件测得的纵向应变、圆周应变与经声学测微计法所得数据相关,纵向应变r=0.85、0.83,圆周应变r=0.82、0.83。与正常心肌比较,心肌梗死后Tomtec法测量GE超声系统所得纵向应变、圆周应变均减低,分别为30.4%和34.4%。结论:Tomtec分析软件可以分析GE Vivid E9超声系统所采集的图像,且与声学测微法所得应变值具有良好的相关性。Tomtec三维左室分析软件可应用于临床多中心合作研究,为研究结果的一致性提供理论基础。

Objective To investigate the clinical value of evaluating left ventricular myocardial strain before and after myocardial infarction using a vendor-independent three-dimensional analysis software(Tomtec).Methods Ten freshly harvested porcine hearts were connected to a pulsatile pump apparatus,and the stroke volume was set to 30-70 ml.Ultrasound sono micrometry crystals were sutured to the epicardium to obtain the corresponding myocardial strain value as the strain gold standard.GE ultrasound machines were used to obtain three-dimensional images of left ventricular full volume before and after myocardial infarction(5 porcine hearts were used to prepare a model of myocardial infarction),and longitudinal strain and circumferential strain were obtained by Tomtec analysis software,and the correlations was analyzed.Results The longitudinal strain and circumferential strain measured by Tomtec software in normal myocardial and myocardial infarction models were related to the data obtained by sono micrometric method,with longitudinal strain r=0.85 and 0.83,and circumferential strain r=0.82 and 0.83.Compared with normal myocardium,the longitudinal and circumferential strains of GE ultrasound system measured by Tomtec method after myocardial infarction were reduced by 30.4%and 34.4%,respectively.Conclusions All images acquired on GE Vivid 9 echocardiographic systems are able to be analyze with Tomtec software and these images correlate well with sono-micrometry.Tomtec three-dimensional left ventricular analysis software can be applied to clinical multicenter collaborative research,providing a theoretical basis for the consistency of research results.