多普勒组织成像速度图定量检测正常左室壁心肌运动的研究

Quantitative Assessment of Normal Left Ventricular Wall Motion by Velocity Mode of Doppler Tissue Imaging

目的 评估多普勒组织成像 (DTI)速度图检测正常室壁心肌运动的诊断价值。方法 48名健康人 ,行2D超声检查 ,分别在 (ap4cv、ap2cv、alax、pslax、pssax(CT)、pssax(PM ) ) 6个切面上按左室壁 16节段分段法观测局部室壁心肌运动 ,在alax上测量室壁节段厚度 ;在每一切面上切换为DTI速度图 ,观察心肌运动的色彩变化和频谱曲线形态特征 ,测量计算各室壁节段心肌运动的PW -DTI速度指标 (Sm、Em、PVGs、PVGe、MVGs、MVGe) ;比较每一切面各室壁节段相应的速度测值 ,并对部分室壁节段在不同切面上相应的速度测值作比较。结果 (1)DTI速度图显示 ,健康人室壁心肌运动色彩均匀、鲜亮 ,同一室壁各节段内膜下心肌相同方向运动速度由基底段至心尖段逐渐降低。 (2 )PW -DTI速度数值显示 :同一室壁心肌相同方向运动速度 (Sm、Em)由基底段向心尖段逐渐降低 ;不同室壁心肌同一方向运动速度 ,室间隔、前壁和前间隔分别低于侧壁、下壁和后壁 ;同一室壁内膜下心肌运动速度大于外膜下心肌运动速度 ;同一室壁心肌沿心脏长轴方向的运动速度大于沿短轴方向的运动速度 ;上述差别均十分显著 (P <0 .0 1或P <0 .0 5 )。 (3 )PW -DTI检测心肌运动速度的重复性 ,在检查者之间和检查者两次检测均较佳。结论 DTI速度图检测心肌运动?

Objective This study was performed to evaluate the diagnostic value of Doppler tissue imaging(DTI) for detection of the movement of normal ventricular wall. Methods The left ventricular wall motion of 48 HEALTH was assessed. In six views(ap4cv,ap2cv,alax,pslax,pssax(CT), pssax(PM)), The regional left ventricular wall motion was observed by 2D echocardiography according to 16 segments. The thickness of myocardial segments was measured in alax. Having switched to DTI in each view, the color coded by DTI of ventricular wall motion and the form of spectrum curve of ventricular wall motion were observed. The markers(Sm, Em, PVGs, PVGe, MVGs, MVGe) of pulsed wave-DTI(PW-DTI) of segmental velocity were measured or calculated. All segmental velocity of each marker was compared with each other in same view. In some specific segments, the velocity of one in a view was compared with that of the same marker in another view.Results (1) The color coded by DTI of ventricular wall motion was well-distributed and bright in HEALTH and endocardial velocity of the same ventricular wall which was in the same direction decreased gradually along cardiac base to cardiac apex.(2)The numeric value of velocity measured by PW-DTI of the same ventricular wall which moved in the same direction decreased gradually along cardiac base to cardiac apex too. In the same direction, myocardial velocity of interventricular septum、anterior wall、anteroseptal wall was respectively lower than that of lateral wall、inferior wall、posterior wall and endocardial velocity was higher than epicardial velocity of the same ventricular wall. In the different direction, endocardial velocity of the same ventricular wall in long-axis direction was higher than that in short-axis direction. All above-mentioned differences were extremely significant( P <0.01 or P <0.05).(3)The repetition of PW-DTI for detection of myocardial velocity was better among infra-examiner and within intra-examiner.Conclusions DTI is a new technique by which detection is quantitative and accurate and by which operation is simple、non-invasive and easy to repeat and DTI is able to reflect exactly the feature of normal ventricular wall motion which is centripetal and synchronous contraction.