四維超聲心動(dòng)圖對(duì)左心室收縮功能的研究
發(fā)布時(shí)間：2018-07-26 07:50
【摘要】：目的： 應(yīng)用四維超聲心動(dòng)圖中的左室四維自動(dòng)定量分析技術(shù)（4-DimensionalAuto Left Ventricular quantification,4DAuto LVQ）評(píng)價(jià)心肌梗死患者收縮功能的變化，并聯(lián)合應(yīng)用四維應(yīng)變（4D Strain）技術(shù)對(duì)心肌梗死患者的梗死部位、范圍進(jìn)行定位、定量分析。旨在探討左室四維定量分析技術(shù)評(píng)價(jià)收縮功能的可行性和應(yīng)用價(jià)值及四維應(yīng)變技術(shù)對(duì)心肌梗死患者缺血心肌或梗死部位及范圍進(jìn)行定位、定量分析。 方法： 選擇30例心肌梗死患者和20例健康志愿者，應(yīng)用4V全容積心臟探頭，啟動(dòng)三平面成像軟件，連續(xù)采集3個(gè)心動(dòng)周期的實(shí)時(shí)動(dòng)態(tài)圖像，即可獲得心尖四腔、心尖兩腔及心尖左室長(zhǎng)軸切面，調(diào)整圖像角度以獲得最佳切面，點(diǎn)擊ejection fraction，，圖像自動(dòng)停留在舒張末期幀，依次勾畫三個(gè)圖像的心內(nèi)膜面，完成后自動(dòng)跳轉(zhuǎn)為收縮末期幀，重復(fù)上面的步驟，軟件自動(dòng)得出左室舒張末期容積（LVEDV）、左室收縮末期容積（LVESV）、左室射血分?jǐn)?shù)（LVEF）、心率（HR）、每搏輸出量（SV）。在4D模式下，經(jīng)胸連續(xù)采集4-6個(gè)心動(dòng)周期的全容積心尖四腔切面圖像，保證圖像幀頻大于心率的40%，如圖像不滿意可手動(dòng)調(diào)節(jié)，得到最佳圖像后，選擇Volume，啟動(dòng)4D Auto LVQ軟件，分別在舒張末期和收縮末期心內(nèi)膜處放置兩個(gè)點(diǎn)，一個(gè)放置在左心室二尖瓣環(huán)連線的中點(diǎn)，一個(gè)放置在心尖部心內(nèi)膜面的頂點(diǎn)位置，軟件自動(dòng)獲取左室舒張末期容積（LVEDV）、左室收縮末期容積（LVESV）、左室射血分?jǐn)?shù)（LVEF）、心率（HR）、每搏輸出量（SV），并在左室四維定量分析技術(shù)的基礎(chǔ)上啟動(dòng)四維應(yīng)變技術(shù)，獲得左心室17個(gè)節(jié)段的收縮末期峰值縱向應(yīng)變（longitudinal strain，LS）。并用彩色編碼的牛眼圖將所有節(jié)段的應(yīng)變值表達(dá)出來(lái)。所有采集的數(shù)據(jù)應(yīng)用SPSS19.0軟件進(jìn)行分析。 結(jié)果： 1心肌梗死組與對(duì)照組HR、年齡差異均無(wú)顯著性意義（P0.05）；應(yīng)用4D Auto LVQ軟件進(jìn)行分析，與對(duì)照組相比，心肌梗死組每搏輸出量（SV）、左室舒張末期容積（LVEDV）、左室收縮末期容積（LVESV）明顯增大，左心室射血分?jǐn)?shù)（LVEF）明顯減少，差異均有統(tǒng)計(jì)學(xué)意義（P0.05）；應(yīng)用RT-3PE軟件進(jìn)行分析，與對(duì)照組相比，心肌梗死組每搏輸出量（SV）、左室舒張末期容積（LVEDV）、左室收縮末期容積（LVESV）明顯增大，左心室射血分?jǐn)?shù)（LVEF）明顯減少，差異均有統(tǒng)計(jì)學(xué)意義（P0.05）。 2應(yīng)用RT-3PE和4D Auto LVQ兩方法測(cè)量的正常對(duì)照組中HR、SV、LVEDV、LVESV、LVEF等各項(xiàng)參數(shù)均無(wú)明顯差異（P0.05），應(yīng)用兩方法測(cè)量的心肌梗死組中HR、SV、LVEDV、LVESV、LVEF等各項(xiàng)參數(shù)均無(wú)明顯差異（P0.05）。 3應(yīng)用4D Auto LVQ技術(shù)測(cè)量的心肌梗死組LVEF和LVEDV，發(fā)現(xiàn)LVEF的減小與LVEDV的增大呈負(fù)相關(guān)（r=-0.720）。 4應(yīng)用四維應(yīng)變技術(shù)得出左心室17個(gè)節(jié)段基底段、中間段、心尖段及心尖帽縱向應(yīng)變，心肌梗死組應(yīng)變值均小于正常對(duì)照組，差異均具有統(tǒng)計(jì)學(xué)意義（P0.05）。 5四維縱向應(yīng)變?cè)谡?duì)照組中左心室不同水平應(yīng)變測(cè)值可發(fā)現(xiàn)如下規(guī)律：左心室收縮期峰值縱向應(yīng)變?cè)谥虚g段呈最大趨勢(shì)，基底段最小，心尖段居中。 結(jié)論： 14D Auto LVQ技術(shù)可以準(zhǔn)確的對(duì)左室收縮功能各項(xiàng)參數(shù)進(jìn)行測(cè)量，并且可以有效的對(duì)節(jié)段性室壁運(yùn)動(dòng)異�；蛞寻l(fā)生心肌形變的左心室收縮功能做出準(zhǔn)確評(píng)價(jià)。 2聯(lián)合應(yīng)用四維應(yīng)變技術(shù)可以準(zhǔn)確的對(duì)左室心肌梗死或心肌缺血部位、范圍進(jìn)行定位、定量分析。
[Abstract]:Objective:
4-DimensionalAuto Left Ventricular quantification (4DAuto LVQ) was used to evaluate the changes of systolic function in patients with myocardial infarction with four dimensional echocardiography, and the location and quantitative analysis of the infarct sites in patients with myocardial infarction were combined with the four dimensional strain (4D Strain) technique. The feasibility and application value of the left ventricular four dimensional quantitative analysis technique to evaluate the systolic function and the four dimensional strain technique were used to locate the ischemic myocardium or infarct location and range of the patients with myocardial infarction.
Method:
In 30 patients with myocardial infarction and 20 healthy volunteers, the 4V full volume heart probe was used and the three plane imaging software was started. The real-time dynamic images of 3 cardiac cycles were collected continuously. The four cavity of the apex, the two cavities of the apex and the long axis of the left ventricle of the apex were obtained. The image angle was adjusted to obtain the best cut surface, and ejection fraction was clicked on the image self. At the end of diastolic frame, the intimal surface of the three images was sequentially outlined, and the end systolic frame was automatically jumps after completion, and the above steps were repeated. The software automatically obtained the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), heart rate (HR), and per stroke output (SV). Under 4D mode, continuous recovery was taken under the chest. A full volume apical four cavity slice image of 4-6 cardiac cycles is set up to ensure that the frame frequency of the image is greater than 40% of the heart rate. If the image is unsatisfactory, the image can be manually adjusted. After the best image is obtained, Volume is selected and the 4D Auto LVQ software is started, and two points are placed at the end diastolic and end-stage end-end endocardium, and one is placed on the left ventricular mitral annulus line. Midpoint, a location placed at the apex of the apical endocardium, the software automatically obtained the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), heart rate (HR), and per stroke output (SV), and the four dimensional strain technique was started on the basis of the left ventricular quantitative analysis technique to obtain 17 segments of the left ventricle. The peak longitudinal strain at the end of contraction (longitudinal strain, LS). The strain values of all segments were expressed with the color coded eye diagram. All the data collected were analyzed by SPSS19.0 software.
Result:
The age difference between the 1 myocardial infarction group and the control group was no significant difference (P0.05), and the 4D Auto LVQ software was used to analyze the stroke volume (SV), the left ventricular end diastolic volume (LVEDV), the left ventricular end systolic volume (LVESV) and the left ventricular ejection fraction (LVEF) in the myocardial infarction group compared with the control group, and the difference was statistically significant. Learning significance (P0.05); compared with the control group, compared with the control group, the stroke volume (SV), left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and left ventricular ejection fraction (LVEF) decreased significantly in the myocardial infarction group, and the difference of left ventricular ejection fraction (LVEF) was significantly decreased (P0.05).
2 the parameters of HR, SV, LVEDV, LVESV, LVEF in the normal control group measured by RT-3PE and 4D Auto LVQ two were not significantly different (P0.05). There were no significant differences in the parameters in the myocardial infarction group measured with two methods.
3 LVEF and LVEDV in myocardial infarction group measured by 4D Auto LVQ technology showed that the decrease of LVEF was negatively correlated with the increase of LVEDV (r=-0.720).
4 the strain of the 17 segments of the left ventricle, the middle segment, the apical segment and the apical cap were obtained by the four dimensional strain technique. The strain values of the myocardial infarction group were all smaller than those of the normal control group, and the difference was statistically significant (P0.05).
The following rules were found in 5 four dimensional longitudinal strain in the left ventricle of the normal control group: the peak longitudinal strain of the left ventricular systole was the largest in the middle segment, the basal segment was the smallest, and the apical segment was middle.
Conclusion:
14D Auto LVQ technology can accurately measure the parameters of left ventricular systolic function, and can effectively evaluate the left ventricular systolic function of segmental wall movement or cardiac muscle deformation.
2 combined with four-dimensional strain technology can accurately locate and quantify the location and range of left ventricular myocardial infarction or myocardial ischemia.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R540.45;R54
本文編號(hào)：2145352
[Abstract]:Objective:
4-DimensionalAuto Left Ventricular quantification (4DAuto LVQ) was used to evaluate the changes of systolic function in patients with myocardial infarction with four dimensional echocardiography, and the location and quantitative analysis of the infarct sites in patients with myocardial infarction were combined with the four dimensional strain (4D Strain) technique. The feasibility and application value of the left ventricular four dimensional quantitative analysis technique to evaluate the systolic function and the four dimensional strain technique were used to locate the ischemic myocardium or infarct location and range of the patients with myocardial infarction.
Method:
In 30 patients with myocardial infarction and 20 healthy volunteers, the 4V full volume heart probe was used and the three plane imaging software was started. The real-time dynamic images of 3 cardiac cycles were collected continuously. The four cavity of the apex, the two cavities of the apex and the long axis of the left ventricle of the apex were obtained. The image angle was adjusted to obtain the best cut surface, and ejection fraction was clicked on the image self. At the end of diastolic frame, the intimal surface of the three images was sequentially outlined, and the end systolic frame was automatically jumps after completion, and the above steps were repeated. The software automatically obtained the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), heart rate (HR), and per stroke output (SV). Under 4D mode, continuous recovery was taken under the chest. A full volume apical four cavity slice image of 4-6 cardiac cycles is set up to ensure that the frame frequency of the image is greater than 40% of the heart rate. If the image is unsatisfactory, the image can be manually adjusted. After the best image is obtained, Volume is selected and the 4D Auto LVQ software is started, and two points are placed at the end diastolic and end-stage end-end endocardium, and one is placed on the left ventricular mitral annulus line. Midpoint, a location placed at the apex of the apical endocardium, the software automatically obtained the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), heart rate (HR), and per stroke output (SV), and the four dimensional strain technique was started on the basis of the left ventricular quantitative analysis technique to obtain 17 segments of the left ventricle. The peak longitudinal strain at the end of contraction (longitudinal strain, LS). The strain values of all segments were expressed with the color coded eye diagram. All the data collected were analyzed by SPSS19.0 software.
Result:
The age difference between the 1 myocardial infarction group and the control group was no significant difference (P0.05), and the 4D Auto LVQ software was used to analyze the stroke volume (SV), the left ventricular end diastolic volume (LVEDV), the left ventricular end systolic volume (LVESV) and the left ventricular ejection fraction (LVEF) in the myocardial infarction group compared with the control group, and the difference was statistically significant. Learning significance (P0.05); compared with the control group, compared with the control group, the stroke volume (SV), left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and left ventricular ejection fraction (LVEF) decreased significantly in the myocardial infarction group, and the difference of left ventricular ejection fraction (LVEF) was significantly decreased (P0.05).
2 the parameters of HR, SV, LVEDV, LVESV, LVEF in the normal control group measured by RT-3PE and 4D Auto LVQ two were not significantly different (P0.05). There were no significant differences in the parameters in the myocardial infarction group measured with two methods.
3 LVEF and LVEDV in myocardial infarction group measured by 4D Auto LVQ technology showed that the decrease of LVEF was negatively correlated with the increase of LVEDV (r=-0.720).
4 the strain of the 17 segments of the left ventricle, the middle segment, the apical segment and the apical cap were obtained by the four dimensional strain technique. The strain values of the myocardial infarction group were all smaller than those of the normal control group, and the difference was statistically significant (P0.05).
The following rules were found in 5 four dimensional longitudinal strain in the left ventricle of the normal control group: the peak longitudinal strain of the left ventricular systole was the largest in the middle segment, the basal segment was the smallest, and the apical segment was middle.
Conclusion:
14D Auto LVQ technology can accurately measure the parameters of left ventricular systolic function, and can effectively evaluate the left ventricular systolic function of segmental wall movement or cardiac muscle deformation.
2 combined with four-dimensional strain technology can accurately locate and quantify the location and range of left ventricular myocardial infarction or myocardial ischemia.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R540.45;R54
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 崔年芳;郭杰;;冠心病心絞痛經(jīng)皮冠狀動(dòng)脈介入治療術(shù)的臨床觀察[J];安徽醫(yī)藥;2011年01期
2 邊曉琳;張連仲;郭曉霞;王雁;趙紅梅;劉淇;鄭玉琴;;實(shí)時(shí)三維超聲心動(dòng)圖評(píng)價(jià)三支冠脈病變患者左室收縮非同步性[J];河南醫(yī)學(xué)研究;2010年02期
3 宋軍;高冬梅;金穎;;應(yīng)變、應(yīng)變率顯像技術(shù)及其在冠心病中的應(yīng)用[J];吉林醫(yī)學(xué);2007年11期
4 姚鳳娟,陸X;超聲心動(dòng)圖新進(jìn)展——應(yīng)變和應(yīng)變率成像技術(shù)[J];臨床超聲醫(yī)學(xué)雜志;2004年06期
5 王雪;張梅;張運(yùn);曲海燕;李小楠;陳良;;左室壁運(yùn)動(dòng)同步性的實(shí)時(shí)三維超聲心動(dòng)圖定量研究[J];臨床超聲醫(yī)學(xué)雜志;2006年11期
6 劉蓉;鄧又斌;劉冰冰;陳斌;楊好意;劉婭妮;余芬;;實(shí)時(shí)三平面超聲心動(dòng)圖測(cè)量左室室壁瘤的左室容積的實(shí)驗(yàn)研究[J];臨床超聲醫(yī)學(xué)雜志;2007年11期
7 姜嵐;謝明星;王新房;袁莉;李玉曼;段鳳霞;;四維自動(dòng)左室定量分析技術(shù)評(píng)價(jià)正常人左室容積及功能的初步研究[J];臨床心血管病雜志;2011年06期
8 馮春光;賈三慶;藤一星;寧?kù)o;王雷;張宇晨;沈璐華;顧復(fù)生;付強(qiáng);;三維超聲評(píng)價(jià)急性心肌梗死再灌注后左室重構(gòu)[J];中國(guó)臨床醫(yī)學(xué);2009年05期
9 張雷;胡燕華;;實(shí)時(shí)三平面超聲心動(dòng)圖在臨床研究中的應(yīng)用[J];內(nèi)蒙古醫(yī)學(xué)雜志;2011年05期
10 丁曉明;鄭哲嵐;;三維縱向應(yīng)變?cè)u(píng)價(jià)左前降支冠狀動(dòng)脈病變患者左心室局部功能[J];中國(guó)臨床醫(yī)學(xué)影像雜志;2013年04期
本文編號(hào)：2145352
本文鏈接：http://sikaile.net/yixuelunwen/fangshe/2145352.html
最近更新
教材專著
