| 摘要: |
| 目的 运用二维斑点追踪成像(2D-STI)技术检测左心室心内膜回声增强患者左心室心内膜下心肌应变参数,探讨左心室心内膜回声增强与心肌缺血及冠状动脉病变的关系。方法 收集我院超声心动图检查存在左心室心内膜回声增强的患者80例,根据Gensini评分标准将受试者分为冠脉无病变组(Gensini评分=0分)、轻度病变组(0＜Gensini评分＜25分)及中重度病变组(Gensini评分≥25分)。记录各组左心室心内膜回声增强的发生率、与病变冠脉供血心肌节段的对应率。测量各处左心室心内膜回声增强的厚度、面积,比较各组以上参数的差异。运用2D-STI技术获取左心室心内膜下心肌整体峰值纵向应变(GLSendo)、心尖四腔心峰值纵向应变(AP4LSendo)、心尖三腔心峰值纵向应变(AP3LSendo)、心尖两腔心峰值纵向应变(AP2LSendo)、心内膜回声增强部位心内膜下心肌峰值纵向应变(LSendo-ee),左心室心内膜下心肌整体峰值环向应变(GCSendo)、左室短轴基底段峰值环向应变(SAXBCSendo)、左室短轴中间段峰值环向应变(SAXMCSendo)、左室短轴心尖段峰值环向应变(SAXACSendo)、心内膜回声增强部位心内膜下心肌峰值环向应变(CSendo-ee),比较各组应变参数的差异。分析左心室心内膜下心肌应变参数及心内膜回声增强的厚度、面积与Gensini评分的相关性。绘制受试者工作特征(ROC)曲线分析各应变参数及心内膜回声增强的厚度、面积对中重度冠状动脉病变的诊断效能。结果 各组左心室心内膜回声增强的发生率比较差异无统计学意义,冠脉病变组左心室心内膜回声增强部位心肌节段与病变冠脉供血心肌节段的对应率均较高。与无病变组对比,轻度病变组GLSendo、AP4LSendo、LSendo-ee、GCSendo、SAXACSendo、CSendo-ee、心内膜回声增强的厚度均增大,差异均有统计学意义(P＜0.05)。与轻度病变组对比,中重度病变组GLSendo、AP4LSendo、AP3LSendo、AP2LSendo、LSendo-ee、GCSendo、SAXBCSendo、SAXMCSendo、CSendo-ee均增大,差异均有统计学意义(P＜0.05)。相关性分析显示,冠脉病变患者GLSendo、AP4LSendo、AP3LSendo、AP2LSendo、GCSendo、SAXBCSendo、SAXMCSendo、心内膜回声增强的厚度与Gensini评分均成正相关(P＜0.05)。ROC曲线分析显示,GLSendo、AP4LSendo、AP3LSendo、AP2LSendo、GCSendo、SAXBCSendo、SAXMCSendo对中重度冠状动脉病变有诊断价值。结论 2D-STI技术可通过评估存在左心室心内膜回声增强的患者心内膜下心肌应变参数,初步判定心肌缺血与冠状动脉病变程度,通过心内膜回声增强的部位推测可能病变的冠状动脉有一定准确性。 |
| 关键词: 超声心动描记术 斑点追踪 左心室 回声增强 冠状动脉疾病 |
| DOI： |
| 投稿时间：2024-03-13修订日期：2024-06-22 |
| 基金项目:泸州市科技计划项目(2023SYF113) |
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| The Two-Dimensional Speckle Tracking Imaging was Used to Assess the Relationship Between Left Ventricular Endocardial Echo Enhancement and Coronary Artery Disease |
| XU Ying,YANG Qingyan,WANG Shijie,WANG Wenyuan,ZHU Weiwei,FAN Zhengchao,XIA Jizhu |
| (Department of Ultrasound Medicine,Affiliated Hospital of Southwest Medical University) |
| Abstract: |
| Objective To utilize two-dimensional speckle tracking tmaging (2D-STI) technique for detecting strain parameters of the subendocardial myocardium in the left ventricle in patients with endocardial echo enhancement, and to explore the relationship between the presence of left ventricular endocardial echo enhancement and myocardial ischemia coronary artery disease. Methods We collected data from 80 patients in our hospital who underwent echocardiography and exhibited left ventricular endocardial echo enhancement. Based on the standard of |
| Key words: Ultrasonic Cardiography Speckle Tracking Left Ventricle Echo Enhancement Coronary Artery Disease |
