本文選題：三維斑點追蹤技術(shù) + 兒童　； 參考：《鄭州大學(xué)》2012年碩士論文

【摘要】：目的 應(yīng)用三維斑點追蹤技術(shù)(three-dimensional speckle tracking,3D-STI)探討正常嬰幼兒、兒童及青少年心肌縱向應(yīng)變、徑向應(yīng)變及圓周應(yīng)變的特征,為臨床應(yīng)用三維斑點追蹤技術(shù)評價兒童左室收縮功能提供參考數(shù)據(jù)。 對象與方法 選取126例3天～15歲健康受試者,按年齡分為5組,A嬰幼兒組(3天～3歲),B學(xué)齡前期組(3～6歲),C學(xué)齡期組(6～10歲),D青春前期組(10～13歲),E青春期組(13～15歲)。經(jīng)胸超聲同時采集左心室心尖四腔切面和心尖兩腔切面圖像后,獲取左心室三維全容積動態(tài)圖像,存儲圖像后運用3D-STI分析軟件進行在線分析。分析獲取左心室心肌收縮期16節(jié)段縱向峰值應(yīng)變(peak longitudinal srain,PLS)、徑向峰值應(yīng)變(peak radial strain,PRS)、圓周峰值應(yīng)變(peak circumferential strain,PCS)及左室整體縱向峰值應(yīng)變(peak global longitudinal srain,PGLS)、左室整體徑向峰值應(yīng)變peak global radial strain,PGRS)及左室整體圓周峰值應(yīng)變(peak global circumferential strain,PGCS)。觀察16節(jié)段PLS、PRS及PCS特征并比較不同年齡組間PGLS、PGRS及PGCS的差異。 結(jié)果 1各組內(nèi)比較 ①PLS測值心尖段中間段基底段,各組內(nèi)部分室壁心尖段與基底段和中間段比較差異有統(tǒng)計學(xué)意義(P0.05)； ②各組內(nèi)部分室壁基底段、中間段、心尖段PRS測值比較差異有統(tǒng)計學(xué)意義(P0.05),同一室壁內(nèi)PRS測值中間段心尖段； ③各組內(nèi)部分室壁基底段、中間段、心尖段PCS測值比較差異有統(tǒng)計學(xué)意義(P0.05)。 2各組間比較 ①PGLS隨年齡增長大致呈遞減趨勢,五組間差異有統(tǒng)計學(xué)意義(P0.05)；其中A組、B組及C組PGLS測值大于D組及E組,差異有統(tǒng)計學(xué)意義(P0.05)； ②PGRS測值各組間分布比較均一,組間差異無統(tǒng)計學(xué)差異(P0.05)； ③PGCS測值隨年齡增長大致呈遞增趨勢,五組間差異有統(tǒng)計學(xué)意義(P0.05)；其中A組PGLS測值小于D組及E組,差異有統(tǒng)計學(xué)意義(P0.05)。 結(jié)論 1.正常兒童左心室16節(jié)段心肌縱向、徑向及圓周應(yīng)變具有自身特征,存在節(jié)段性差異,這種局部心肌應(yīng)變分布的不均一可能與心肌纖維排列及不同時期兒童心臟的生理解剖特點有關(guān)。 2.不同年齡組正常兒童左室心肌功能分布存在不均一性,主要體現(xiàn)在嬰幼兒組與青春期組之間的差異。左心室整體峰值應(yīng)變隨年齡增長具有一定的規(guī)律：縱向峰值應(yīng)變隨年齡增長遞減,圓周峰值應(yīng)變隨年齡增長遞增,徑向峰值應(yīng)變隨年齡增長無明顯變化。
[Abstract]:Purpose Three-dimensional speckle tracking3D-STI technique was used to study the characteristics of longitudinal, radial and circumferential strain of myocardium in normal infants, children and adolescents, and to provide reference data for clinical evaluation of left ventricular systolic function by using three-dimensional speckle tracing technique. Objects and methods 126 healthy subjects aged from 3 days to 15 years old were divided into 5 groups according to their ages: 3 days old and 3 years old, 6 years old, 10 years old, prepuberty group, 13 years old, and E group, 13 years old and 15 years old, respectively. The left ventricular three-dimensional full-volume dynamic images were obtained by transthoracic ultrasound after the images of the four-chamber and two-chamber sections of the left ventricular apex were collected simultaneously. The images were stored and analyzed online by 3D-STI software. The longitudinal peak strain of 16 segments of left ventricular myocardium during systolic period, peak longitudinal straining, radial peak strain, peak radial straining, peak circumferential straining, and left ventricular whole longitudinal peak strain peak global longitudinal srainp PGLSs, left ventricular global radial peak strain peak global radial were obtained. The peak strain peak global circumferential strainn (PGCSS) and the peak circumferential strain of the left ventricle (PGCSs) were also found in the left ventricle. To observe the characteristics of PLSS-PRS and PCS in 16 segments and to compare the difference of PGRS and PGCS among different age groups. Result 1Intra-group comparison There were significant differences between the apical segment and the basal segment and the middle segment in the apical segment of the ventricular wall in each group (P 0.05), and there was a significant difference between the apical segment of the ventricular wall and the basal segment and the middle segment in each group. 2There were significant differences in PRS between the basal segment, middle segment and apical segment of the ventricular wall in each group (P 0.05), and the apical segment of the middle segment was measured by PRS in the same ventricular wall. 3There were significant differences in PCS between the basal segment, middle segment and apical segment of ventricular wall in each group (P 0.05). 2 comparison between groups The 1PGLS of group A and group C was significantly higher than that of group D and E, and the difference was statistically significant among the five groups (P 0.05), and the values of PGLS in group A and group C were higher than those in group D and group E. The distribution of 2PGRS was uniform among the groups, and there was no statistical difference among the groups (P 0.05). The 3PGCS values showed an increasing trend with the increase of age, and the differences among the five groups were statistically significant (P 0.05), and the PGLS values in group A were lower than those in group D and group E (P 0.05). Conclusion 1. The longitudinal, radial and circumferential strains of 16 segments of left ventricle in normal children have their own characteristics, and there are segmental differences. The heterogeneity of the local myocardial strain distribution may be related to the arrangement of myocardial fibers and the physiological and anatomical characteristics of children's heart at different stages. 2. The distribution of left ventricular myocardial function in normal children of different age groups was uneven, mainly reflected in the difference between infant and adolescent groups. The global peak strain of left ventricle has a certain regularity with age: longitudinal peak strain decreases with age, circumferential peak strain increases with age, radial peak strain does not change with age.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R725.4

【共引文獻】

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1 李蕾;改進的解剖M型超聲對左室短軸局部心肌運動功能的檢測[D];中國人民解放軍軍醫(yī)進修學(xué)院;2008年

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