比較三維和二維斑點追蹤技術(shù)評價左室收縮功能
發(fā)布時間：2018-08-17 10:16
【摘要】：目的：比較三維斑點追蹤技術(shù)(3DT)和二維斑點追蹤技術(shù)(2DT)評價正常人左心室心肌縱向、圓周和徑向應(yīng)變,探討3DT在評價左心室收縮功能的應(yīng)用價值。 方法：我院健康體檢者46例,經(jīng)胸超聲同時采集左心室心尖四腔和兩腔切面圖像后,獲取左心室三維全容積動態(tài)圖像,存儲圖像后啟動3DT分析軟件進(jìn)行脫機(jī)分析,獲取左心室縱向、圓周、徑向應(yīng)變和面積應(yīng)變,左心室舒張末期容積、收縮末期容積及左心室射血分?jǐn)?shù),同時記錄運(yùn)用3DT進(jìn)行存儲圖像和分析圖像所用時間；經(jīng)胸超聲采集并存儲左心室短軸二尖瓣水平、乳頭肌水平和心尖水平二維圖像和心尖四腔切面、兩腔切面和左心室長軸切面二維圖像,啟動2DT分析軟件脫機(jī)分析,獲取左心室縱向、圓周和徑向應(yīng)變,同時記錄運(yùn)用2DT進(jìn)行存儲圖像和分析圖像所用時間,Simpson法測量左心室舒張末期容積、收縮末期容積及左心室射血分?jǐn)?shù)。分析并比較上述兩種方法。 結(jié)果：①運(yùn)用3DT時存儲圖像和分析圖像所用時間均明顯短于2DT(P0.05)。 ②與2DT相比,應(yīng)用3DT測得的EDV、LVEF較小,差異具有統(tǒng)計學(xué)意義(P均0.05),而ESV兩者間差異無統(tǒng)計學(xué)意義(P0.05)。 ③3DT測得的左心室整體縱向收縮期峰值應(yīng)變明顯低于2DT(P0.05),整體圓周收縮期峰值應(yīng)變明顯高于2DT(P0.05),兩種方法測得的整體徑向收縮期峰值應(yīng)變差異無統(tǒng)計學(xué)意義(P0.05)。 ④從二尖瓣水平至心尖水平,3DT與2DT測得的左心室心肌3個方向的應(yīng)變變化規(guī)律一致,即：左室短軸徑向收縮期峰值應(yīng)變從心尖水平至乳頭肌水平再至二尖瓣水平呈逐漸增大的趨勢,而左室短軸圓周和左室長軸縱向收縮期峰值應(yīng)變從心尖水平至乳頭肌水平再至二尖瓣水平呈逐漸減小的趨勢(P均0.05)。 ⑤Pearson相關(guān)分析表明3DT整體應(yīng)變參數(shù)GLS、GCS、GRS、 GAS與LVEF均有很好的相關(guān)性,其中GLS、GCS、GAS與LVEF呈負(fù)相關(guān)(r1=-0.72, P10.05; r2=-0.70, P20.05; r3=-0.81, P30.05), GRS與LVEF呈正相關(guān)(r4=0.68,P40.05),其中GAS與LVEF的相關(guān)性較高。 ⑥應(yīng)用3DT和2DT兩種方法測得左心室整體縱向、圓周和徑向收縮期峰值應(yīng)變的研究者內(nèi)和研究者間的變異系數(shù)均15%,并且研究者內(nèi)和研究者間差異度之間差異無統(tǒng)計學(xué)意義(P均0.05)。 結(jié)論：①3DT是一種方便、快速、具有可重復(fù)性的評價左心室心肌縱向、徑向和圓周應(yīng)變的新方法,3DT較2DT在采集圖像和脫機(jī)分析方面更省時、高效,是評價室壁運(yùn)動很有前景的工具。 ②AS將是一個極有潛力的評價左心室收縮功能的指標(biāo)。圖9幅,表6個,參考文獻(xiàn)23篇。
[Abstract]:Objective: to evaluate the longitudinal, circumferential and radial strain of left ventricular myocardium by three-dimensional speckle tracing (3DT) and two-dimensional speckle tracing (2DT), and to evaluate the value of 3DT in evaluating left ventricular systolic function. Methods: 46 cases of healthy examination in our hospital were examined. The images of left ventricular apical four lumen and two lumen were collected simultaneously by transthoracic ultrasound, and the 3D dynamic images of left ventricle were obtained. After the images were stored, 3DT analysis software was started for offline analysis. The left ventricular longitudinal, circumferential, radial strain and area strain, left ventricular end-diastolic volume, end-systolic volume and left ventricular ejection fraction were obtained, and the time taken to store and analyze the images with 3DT was recorded. Two-dimensional images of left ventricular short axis mitral valve level, papillary muscle level and apical level were collected and stored by transthoracic ultrasound, and two-dimensional images of apical four-chamber, two-chamber and left ventricular long axis were collected and stored, and 2DT analysis software was started to analyze offline images. The longitudinal, circumferential and radial strains of the left ventricle were obtained, and the left ventricular end-diastolic volume, end-systolic volume and left ventricular ejection fraction (LVEF) were measured by the time Simpson method using 2DT to store and analyze the images. The above two methods are analyzed and compared. Results when using 3DT, the time of storing and analyzing images was significantly shorter than that of 2DT (P0.05). Compared with 2DT, the EDV / LVEF measured by 3DT was smaller than that of 2DT. The difference was statistically significant (P0.05), but there was no significant difference between the two ESV (P0.05). The peak strain of left ventricular whole longitudinal systolic phase measured by 33DT was significantly lower than that of 2DT (P0.05), and the peak strain of whole circumferential systolic period was significantly higher than that of 2DT (P0.05). There was no significant difference in the peak global radial systolic strain between the two methods (P0.05). 4 the strain changes in three directions of left ventricular myocardium measured by 2DT from mitral valve level to apical level were the same. That is to say, the peak strain of left ventricular short axis radial systolic phase is gradually increasing from apical level to papillary muscle level to mitral valve level. But the peak strain of left ventricular short axis circumference and left ventricular long axis longitudinal systolic phase decreased gradually from apical level to papillary muscle level to mitral valve level (P0. 05). 5Pearson correlation analysis showed that 3DT global strain parameter GLS- GCS GCSs. There is a good correlation between GAS and LVEF, Among them, there was a negative correlation between GCS gas and LVEF (r1 + -0. 72, P 10. 05; r2 + -0. 70, P20. 05; r3 + -0. 81; P3. 05), GRS and LVEF). The correlation between GAS and LVEF was higher. 6 the global longitudinal of left ventricle was measured by 3DT and 2DT. The coefficient of variation of peak strain of circumference and radial contraction was 15% and there was no significant difference between researchers and researchers (P 0.05). Conclusion the new method of evaluating the longitudinal, radial and circumferential strain of left ventricular myocardium is a convenient, rapid and reproducible method. Compared with 2DT, it is more time-saving and more efficient in image acquisition and off-line analysis. 2AS will be a potential indicator of left ventricular systolic function. There are 9 figures, 6 tables and 23 references.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R540.45
本文編號：2187293
[Abstract]:Objective: to evaluate the longitudinal, circumferential and radial strain of left ventricular myocardium by three-dimensional speckle tracing (3DT) and two-dimensional speckle tracing (2DT), and to evaluate the value of 3DT in evaluating left ventricular systolic function. Methods: 46 cases of healthy examination in our hospital were examined. The images of left ventricular apical four lumen and two lumen were collected simultaneously by transthoracic ultrasound, and the 3D dynamic images of left ventricle were obtained. After the images were stored, 3DT analysis software was started for offline analysis. The left ventricular longitudinal, circumferential, radial strain and area strain, left ventricular end-diastolic volume, end-systolic volume and left ventricular ejection fraction were obtained, and the time taken to store and analyze the images with 3DT was recorded. Two-dimensional images of left ventricular short axis mitral valve level, papillary muscle level and apical level were collected and stored by transthoracic ultrasound, and two-dimensional images of apical four-chamber, two-chamber and left ventricular long axis were collected and stored, and 2DT analysis software was started to analyze offline images. The longitudinal, circumferential and radial strains of the left ventricle were obtained, and the left ventricular end-diastolic volume, end-systolic volume and left ventricular ejection fraction (LVEF) were measured by the time Simpson method using 2DT to store and analyze the images. The above two methods are analyzed and compared. Results when using 3DT, the time of storing and analyzing images was significantly shorter than that of 2DT (P0.05). Compared with 2DT, the EDV / LVEF measured by 3DT was smaller than that of 2DT. The difference was statistically significant (P0.05), but there was no significant difference between the two ESV (P0.05). The peak strain of left ventricular whole longitudinal systolic phase measured by 33DT was significantly lower than that of 2DT (P0.05), and the peak strain of whole circumferential systolic period was significantly higher than that of 2DT (P0.05). There was no significant difference in the peak global radial systolic strain between the two methods (P0.05). 4 the strain changes in three directions of left ventricular myocardium measured by 2DT from mitral valve level to apical level were the same. That is to say, the peak strain of left ventricular short axis radial systolic phase is gradually increasing from apical level to papillary muscle level to mitral valve level. But the peak strain of left ventricular short axis circumference and left ventricular long axis longitudinal systolic phase decreased gradually from apical level to papillary muscle level to mitral valve level (P0. 05). 5Pearson correlation analysis showed that 3DT global strain parameter GLS- GCS GCSs. There is a good correlation between GAS and LVEF, Among them, there was a negative correlation between GCS gas and LVEF (r1 + -0. 72, P 10. 05; r2 + -0. 70, P20. 05; r3 + -0. 81; P3. 05), GRS and LVEF). The correlation between GAS and LVEF was higher. 6 the global longitudinal of left ventricle was measured by 3DT and 2DT. The coefficient of variation of peak strain of circumference and radial contraction was 15% and there was no significant difference between researchers and researchers (P 0.05). Conclusion the new method of evaluating the longitudinal, radial and circumferential strain of left ventricular myocardium is a convenient, rapid and reproducible method. Compared with 2DT, it is more time-saving and more efficient in image acquisition and off-line analysis. 2AS will be a potential indicator of left ventricular systolic function. There are 9 figures, 6 tables and 23 references.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R540.45
【參考文獻(xiàn)】
相關(guān)期刊論文 前2條
1 白姣,鄧又斌,劉紅云,楊好意,畢小軍,常青,潘敏;心肌運(yùn)動速度和應(yīng)變率評價不同程度心肌缺血[J];中華超聲影像學(xué)雜志;2004年10期
2 孟慶國;尹立雪;李春梅;左明良;羅安果;;超聲斑點成像技術(shù)評價左心室長軸心肌節(jié)段應(yīng)變與位移[J];中華超聲影像學(xué)雜志;2006年10期
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