三种超声诊断方法评价冠心病患者室壁节段运动异常的应用比较

Comparison of three different echocardiographic methods applicated in the evaluation of abnormal ventricular wall motion in patients with coronary heart disease

目的:对比研究常规二维超声心动图(2DE)、二维斑点追踪超声心动图(2DE-STE)、左心腔超声造影(LVO)三种方法评价冠心病患者室壁节段运动异常(RWMA)的临床价值。方法:选取武汉大学人民医院经冠状动脉造影(CAG)确诊为冠状动脉硬化性心脏病的50例患者的2DE、2DE-STE、LVO检查图像进行回顾性分析,将其数据分别与CAG结果进行对照分析,评估三种模式下评估节段室壁运动异常的准确性、一致性,对比分析2DE和LVO两种模式下左心室节段显示率以及在2DE和LVO两种模式下不同医师应用双平面法测量LVEF的一致性。结果:LVO模式下左室心肌节段显示率(99.88%)较常规2DE(88.1%)显著增高,左室内膜及心腔内结构显示更清晰;LVO评价左室壁节段运动异常的准确性较常规2DE及2DE-STE高、一致性更好;LVO较2DE测量LVEF的一致性更好。结论:LVO能更好地显示左室心内膜边界及心肌节段,因此能更加准确地诊断左室壁节段运动异常,并且测量左室射血功能的可重复性更好。

Objective:To compare the clinical value of conventional two-dimensional echocardiography(2DE), two-dimensional dot tracking echocardiography(2DE-STE), and left ventricular contrast echocardiography(LVO) in the evaluation of left ventricular reginal wall motion abnormal(RWMA) in patients with coronary heart disease.Methods:The 2DE, 2DE-STE, and LVO images of 50 patients with coronary atherosclerotic heart disease diagnosed by coronary angiography(CAG) in our hospital were retrospectively analyzed.The data were compared with the results of CAG to evaluate the accuracy and consistency of segmental wall motion abnormalities in three modes.The display rates of left ventricular segments in 2DE and LVO modes and the consistency of left ventricular LVEF measured by double plane method in 2DE and LVO modes were compared and analyzed.Results:In LVO mode, the display rate of left ventricular myocardial segments(99.88%) was significantly higher than that of conventional 2DE(88.1%), and the display of left ventricular endocardium and intracardiac structure was clearer.The accuracy of LVO in the evaluation of abnormal left ventricular wall motion was higher and better than that of conventional 2DE and 2DE-STE, and the consistency of LVO was better than that of 2DE.Conclusion:LVO can better display the left ventricular endocardial boundary and myocardial segments, so it could diagnoze the abnormal motion of the left ventricular wall and measure the left ventricular ejection function more accurately.