二维斑点追踪成像与三维容积成像对左心房时相功能的评价比较

Evaluation of phasic function of left atrium by two-dimensional speckle tracing imaging and three-dimensional volumetric imaging

目的应用二维斑点追踪成像(2D-STI)技术定量评价左心房(LA)时相功能,并与三维容积(3D-EV)评价进行对比研究。方法选取2018年10月至2019年10月于首都医科大学附属北京朝阳医院接受经胸超声心动图检查诊断为LA增大的患者89例,根据左心房最大容积指数(LAVImax)将其分为LA轻度增大组41例、LA中度增大组27例和LA重度增大组21例。另选取LA大小正常者29例。应用3D-EV获取左心房储器功能(LARS)、左心房管道功能(LACD)、左心房泵功能(LACT);2D-STI获取左心房储器应变(LASr)、左心房管道应变(LAScd)、左心房收缩应变(LASct)。结果LARS、LACD和LACT均与LAVImax呈负相关(r=-0.772、-0.645、-0.735,P均<0.01)。LARS、LACD和LACT在4组间比较,差异均有统计学意义(P均<0.01)。进一步两两比较,LA大小正常组与LA轻度增大组、LA中度增大组与LA重度增大组的LARS(P=0.078、0.101)、LACD(P=0.112、0.483)、LACT(P=0.299、0.066)差异均无统计学意义。LASr、LAScd、LASct均与LAVImax呈负相关(r=-0.797、-0.703、-0.698,P均<0.01)。LASr、LAScd、LASct在4组间比较,差异均有统计学意义(P均<0.001)。进一步两两比较,LASr和LASct在4组间两两比较,差异均有统计学意义(P均<0.05);LAScd在LA大小正常组分别与LA轻度增大组、LA中度增大组、LA重度增大组比较,以及LA轻度增大组与LA重度增大组比较时,差异均有统计学意义(P均<0.05)。结论2D-STI及3D-EV评价均显示LA时相功能随LA增大而减小。2D-STI可更早期发现LA时相功能异常,其可能比3D-EV评估LA时相功能更敏感。

Objective To quantitatively evaluate the left atrial(LA)phasic function by two-dimensional speckle tracing imaging(2D-STI)and three-dimensional volume(3D-EV).Methods A total of 118 patients were selected,including 89 patients diagnosed with LA enlargement by chest echocardiography at Beijing Chaoyang Hospital Affiliated to Capital Medical University from October 2018 to October 2019,and 29 patients with normal LA size.According to the left atrial maximum volume index(LAVImax),the patients were divided into a normal LA group(29 cases),a slightly increased LA group(41 cases),a moderately increased LA group(27 cases),and a severely increased LA group(21 cases).Left atrial storage function(LARS),left atrial duct function(LACD),and left atrial pump function(LACT)were obtained by 3D-EV.Left atrial storage strain(LASr),left atrial duct strain(LAScd),and left atrial systolic strain(LASct)were obtained using 2D-STI.Results LARS,LACD,and LACT were negatively correlated with LAVImax(r=-0.772,-0.645,and-0.735,respectively;P<0.01).LARS,LACD,and LACT differed significantly among the four groups(P<0.01 for all).Further pair-wise comparison showed that there were no significant differences in LARS(P=0.078,0.101),LACD(P=0.112,0.483),or LACT(P=0.299,0.066)between the normal LA size group and the slightly increased LA group,and between the moderately increased LA group and the severely increased LA group.LASr,LAScd,and LASct were negatively correlated with LAVImax(r=-0.797,-0.703,and-0.698,respectively;P<0.01).Further pairwise comparison showed that there were statistically significant differences in LASr and LASct between the four groups(P<0.05 for all).There were statistically significant differences in LAScd between the normal LA size group and the slightly increased LA group,the moderately increased LA group,and the severely increased LA group,as well as between the slightly increased LA group and the severely increased LA group(P<0.05 for all).Conclusion Both 2D-STI and 3D-EV evaluations showed that the time phase function of the LA decreases with the increase of LA.2D-STI can detect abnormal LA phase function earlier and may be more sensitive than 3D-EV in evaluating LA phase function.