摘要
目的探讨三维斑点追踪显像技术(3D-STI)测得的心肌应变值、位移值在定量评估左心室收缩功能方面的应用价值。方法健康志愿者72名,应用Phillip Sonos iE33超声仪经胸行超声检查,分别采集并储存三维全容积动态图像和二维图像,输入TomTec工作站;再分别应用4DLV-Analysis 3.0和Cardiac Performance Analysis分析软件获取左心室三维和二维各心肌应变值、位移值和三维左心室射血分数(3DLVEF)等参数,并将这两种方法测得的心肌应变值和位移值与3D-LVEF间进行相关性分析。结果 3D-STI测得的各心肌应变值和位移值中,除环向位移值(CD)与身高呈负相关、与性别呈正相关,纵向位移值(LD)与性别呈负相关(P值均<0.05)外,其他各心肌应变值和位移值与年龄、身高、体重、心率和性别均不相关(P值均>0.05)。3D-STI测得的整体应变值(3DS,r=-0.880)、纵向应变值(LS,r=-0.770)、径向应变值(RS,r=0.840)、环向应变值(CS,r=0.860)与3D-LVEF均具有较强的相关性(P值均<0.001);3D-STI测得的整体位移值(3DD,r=0.720)和径向位移值(RD,r=0.871)与3D-LVEF具有较强的相关性(P值均<0.001),LD(r=0.374)和CD(r=0.262)亦与3D-LVEF具有一定的相关性(P值均<0.05)。二维斑点追踪显像技术(2D-STI)测定的心肌应变各值中,LS(r=-0.530)、RS(r=0.380)和CS(r=-0.350)均与3D-LVEF具有一定的相关性(P值均<0.005)。2D-STI测定的心肌位移各值中,仅RD(r=0.370,P=0.003)与3D-LVEF间具有一定的相关性,LD和CD与3D-LVEF不相关(P值均>0.05)。经差异性分析,3D-STI、2D-STI测得的各心肌应变值在观察者内和观察者间的平均比值均接近于1,提示重复性均较好。结论三维应变较位移能更客观、准确地反映心肌的运动,尤其是3DS可以作为临床评价左心室收缩功能的一个新指标。
Objective To measure the left ventricular myocardial strain and displacement by using three- dimensional speckle tracking imaging（3D-STI）and to explore their role in assessment of left ventricular systolic function. Methods Transthoracic echocardiography was performed on 72 healthy volunteers by using Phillip Sonos iE33. Two-and three-dimension full-volume images were obtained and transferred to TomTec workstation. Two- and three-dimension myocardial strain and displacement of left ventricle and three-dimension left ventricular ejection fraction （3D-LVEF） were analyzed by four-dimension left ventricular function software （4D LVF3.0） and Cardiac Performance analysis software. Correlations between myocardial strain, displacement and 3D-LVEF were assessed by SPSS 15.0. Results Of the myocardial strain and displacement measured by 3D-STI, circumferential displacement （CD） was negatively correlated with body height and positively correlated with gender （all P〈0.05）; longitudinal displacement （LD） was negatively correlated with gender （P〈0.05）; the other myocardial strain and displacement were not correlated with age, body height, body weight, heart rate or gender （all P〉0. 05） ; the total three-dimensional strain （3DS, r=-0. 880）, longitudinal strain （LS, r = - 0. 770）, radial strain （RS, r = 0. 840）, circumferential strain （CS, r = 0. 860）, total displacement （3DD, r = 0. 720） and radial displacement （RD, r = 0.871 ） were significantly correlated with 3D-LVEF （all P〈0.001 ） ; LD （ r = 0. 374） and CD （ r = 0. 262） were also correlated with 3D-LVEF （both P〈 0.05）. Of the myocardial strain measured by 2D-STI, LS （ r = - 0. 530）, RS （ r = 0. 380） and CS （ r = - 0. 350） were significantly correlated with 3D-LVEF （all P〈0. 005）. Of the displacement measured by 2D-STI, RD was correlated with 3D-LVEF （r = 0. 370, P = 0. 003）, while LD or OD were not correlated with 3D-LVEF （both P〈0.05）. The intra-observer and inter-observer reproducibility analysis showed fairly good results. Conclusion Three-dimension strain can display myocardial motion more objectively and accurately as compared with three-dimension displacement. 3DS appears to be a new and promising parameter for the assessment of left ventricular systolic function. （Shanghai Med J, 2014, 37： 564-567）
出处
《上海医学》
CAS
CSCD
北大核心
2014年第7期564-567,共4页
Shanghai Medical Journal
关键词
斑点追踪显像
三维应变
收缩功能
左心室
Three-dimensional echocardiography
Speckle-tracking strain
Systolic function
Left ventricle
