斑点追踪成像技术在心肌梗死左室心肌应变能力中的应用

摘要

目的:探讨超声斑点追踪成像(speckle tracking imaging,STI)技术评价心肌梗死患者左室心肌整体和局部应变的价值.方法:收集医院60例确诊为前壁心肌梗死患者,将同期体检健康志愿者60例作为正常对照.分别收集2组心尖位左室长轴3个切面高帧频二维动态图像,以自动功能成像软件(automated functional imaging,AFI)测量左室18节段峰值收缩期应变(S)、切面峰值收缩应变(GLS)及左室长轴平均总应变(GLS-Avg),分析GLS-Avg与左室射血分数(left ventricular ejection fraction,LVEF)的相关性；比较2组患者GLS-Avg.结果:前壁心肌梗死患者左室18节段S值自基底段向心尖段逐渐增加,各壁间差异无统计学意义(P＞0.05)；前壁心肌梗死患者各节段壁应变绝对值低于正常对照组(P＜0.05).GLS-Avg与LVEF具有良好相关性(r=0.93,P＜0.05).结论:斑点追踪成像技术能定量测定心肌梗死患者左室和整体心肌的变化.%Objective To study the application of speckle tracking imaging(STI) technology in myocardial infarction patients with left ventricular global and local strain. Methods Sixty cases of myocardial infarction patients were selected, and another sixty healthy patients were in control group. Left ventricular apical long-axis positions were recorded in three two-dimensional slices of high frame rate dynamic images. Left ventricular peak systolic strain in paragraph 18(S), the section peak systolic strain(GLS) and left ventricular long axis of the average total strain(GLS-Avg) of all cases were measured by automated functional imaging(AFI). The relationship of GLS-Avg and left ventricular ejection fraction(LVEF) was analyzed. Results Paragraph 18(S) values of left ventricle from the basal to apical segments gradually increased in control group. The intramural difference was not statistically significant(P>0.05), and strain of the wall segment in myocardial infarction group was lower than that of the control group(P<0.05). GLS-Avg correlated well with LVEF(r=0.93, P<0.05). Conclusion Speckle tracking imaging can determine local and global left ventricular myocardial deformation in myocardial infarction patients.