三维斑点追踪成像评价小儿膜周部室间隔缺损左心室局部收缩功能

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摘要目的：应用三维斑点追踪成像（3D-STI）技术定量评价小儿膜周部室间隔缺损（PmVSD）左心室局部收缩功能变化。方法：PmVSD小儿40例（PmVSD组），年龄、性别相匹配的对照组35例。采集左心室三维全容积图像，运用3D-STI技术测量2组对象收缩期左心室16节段的圆周、纵向、径向峰值应变，比较2组间各参数的差异性，并进一步分析其与左室射血分数、左室容量负荷参数的相关性。结果：PmVSD组左室各节段三个方向峰值应变测值大多数均较正常组增大，其中前、侧壁基底段和侧、后壁中间段的纵向峰值应变及侧壁、下间隔壁中间段的圆周峰值应变和侧壁、下间隔壁中间段及基底段的径向峰值应变差异有统计学意义（P＜0.05）；纵向、圆周、径向峰值应变均分别与左心室舒张末容积呈正相关。结论：3D-STI技术可敏感地检出PmVSD小儿左心室局部收缩功能的异常改变，具有一定的临床应用价值。

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	王珍
	田新桥
	付定虎
	刘敏
	詹坤高
	吴道珠

关键词 ：超声心动描记术；三维斑点追踪；室间隔缺损；心室功能, 左

Abstract：Objective: To evaluate regional left ventricular (LV) systolic function in pediatric with perimembranous ventricular septal defect (PmVSD) using three-dimensional speckle tracking imaging (3D-STI). Methods: Transthoracic full-volume 3D images were obtained in 40 patients with PmVSD and 35 age-and sex-matched controls. The full-volume 3D datasets were recorded, 3D-STI analysis provided measures of peak circumferential, radial, and longitudinal strain in 16 LV segments (6 basal, 6 mid, and 4 apical), left ventricular end systolic and end diastolic volumes (LVESV and LVEDV) were automatic measured. The strain values were compared between the two groups. Correlation analysis between LVEDV, LVESV, LVEF and LV systolic strain values were made respectively. Results: Compared with the control group, multidirectional strains for almostly all segments strain values were higher in patients with PmVSD, especially the peak systolic longitudinal strain in LV anterior, lateral wall basal segments, lateral, posterior wall middle segments and the peak systolic circumferential strain in LV lateral, inferior-septum wall middle segments and peak systolic radial strain in LV inferior-septum, lateral wall middle segments and basal segments were significantly higher than that of the control group (P<0.05). Among strain parameters, averege peak longitudinal strain exhibited the highest correlation with LVEDV. There were no significant differences between two groups in LVEF. Conclusion: 3D-STI is able to confirm regional LV dysfunction in pediatric patients with PmVSD.

Key words： echocardiography three-dimensional speckle tracking ventricular septal defect ventricular function, left

收稿日期: 2015-01-04

通讯作者: 田新桥，主任医师，硕士生导师，Email：tianxq2005@ 163.com。现工作单位：河南省人民医院超声科。

作者简介: 王珍（1989-），女，江西抚州人，硕士生。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2015/V45/I7/507

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