二维斑点追踪成像与组织多普勒成像技术评价矽肺患者右心室收缩功能的早期变化-东南大学学报医学版

二维斑点追踪成像与组织多普勒成像技术评价矽肺患者右心室收缩功能的早期变化

单位：东南大学医学院附属南京市胸科医院医学影像二科, 江苏南京 210029

分类号：R135.2;R445

出版年·卷·期（页码）：2016·35·第四期（555-559）

摘要：

目的：应用二维斑点追踪成像技术（2D-STI）与组织多普勒成像技术（TDI）评价矽肺患者右心室收缩功能的早期变化。方法：选取我院就诊的矽肺患者34例（为矽肺组）以及性别、年龄相匹配的健康成人36例（为对照组），均进行常规超声心动图检查，获得常规超声右心参数；2D-STI获得右心室游离壁及右心室室间隔面的基底段、中间段、心尖段收缩期纵向应变；TDI模式下分别应用组织追踪成像技术（TTI）、脉冲组织多普勒技术（PW-TDI）及定量组织速度成像技术（QTVI）获得右心室游离壁三尖瓣环收缩期位移（TAPSE）、Tei指数、右心室游离壁三尖瓣环收缩期峰值速度（TAPVs）。结果：（1）常规超声心动图参数：与对照组比较，矽肺组右心腔内径、肺动脉收缩压（PASP）、右室面积变化率（RVFAC）差异无统计学意义（P>0.05）；（2） 2D-STI参数：矽肺组较对照组右心室游离壁与右心室室间隔面的基底段、中间段、心尖段收缩期纵向应变均减低（P<0.05）；（3） TDI参数：与对照组比较，矽肺组TAPSE、TAPVs降低，Tei指数升高（P<0.05）。结论：2D-STI与TDI可以成为评价矽肺患者右心室收缩功能早期变化的手段。

Objective:To assess the early changes of right ventricular contractile function in silicosis patients using 2D-STI and TDI. Methods:Thirty-four silicosis patients were enrolled in silicosis group(group S) and 36 age- and gender-matched healthy adults were recruited as control group(group C) in this study. After admission both groups were subjected to conventional ultrasound cardiogram(UCG) to get regular right ventricle parameters and then using 2D-STI to obtain systolic longitudinal strains in basal segment, middle segment and apex segment from both right ventricular free wall and right ventricular septum, respectively. Subsequently, we utilized TTI(tissue tracing imaging), PW-TDI(pulsed wave tissue Doppler imaging) and QTVI (quantitative tissue velocity imaging) to respectively acquire TAPSE (tricuspid annular plane systolic excursion), Tei Index and TAPVs (tricuspid annular peak systolic velocity) in TDI mode. Results:(1) For conventional UCG parameters:compared with group C, no statistically significant differences in right heart diameter, PASP and RVFAC were observed(P>0.05);(2) For 2D-STI parameters:strain S in basal segment, middle segment and apex segment from both right ventricular free wall and right ventricular septum declined in group S(P<0.05);(3) For TDI parameters:in comparison with group C, a dropping in TAPSE and TAPVs and a climbing in Tei Index were detected in group S. Conclusion:In clinical practice 2D-STI and TDI can be utilized as a useful tool for evaluating the early changes of right ventricular contractile function in silicosis patients.

参考文献：

[1] 孙振文.中西医结合治疗矽肺合并肺源性心脏病和心力衰竭的疗效观察[J].职业与健康,2012(24):3065-3066.
[2] CAMELI M,LISI M,RIGHINI F M,et al.Speckle tracking echocardiography as a new technique to evaluate right ventricular function in patients with left ventricular assist device therapy[J].J Heart & Lung Transplantation,2013,32(4):424-430.
[3] SEVIMLI S,GUNDOGDU F,AKSAKAL E,et al.Right ventricular strain and strain rate properties in patients with right ventricular myocardial infarction[J].Echocardiography,2007,24(7):732-738.
[4] CARLSSON M,UGANDER M,HEIBERG E,et al.The quantitative relationship between longitudinal and radial function in left,right,and total heart pumping in humans[J].Am J Physiology,2007,293(1):H636-644.
[5] HADDAD F,DOYLE R,MURPHY D J,et al.Right ventricular function in cardiovascular disease,part Ⅱ:pathophysiology,clinical importance,and management of right ventricular failure[J].Circulation,2008,117(13):1717-1731.
[6] 刘敏.右心功能超声评估进展[J].心血管病学进展,2013,34(4):540-543.
[7] 吴红宁,曹怡,王燕,等.应用二维斑点追踪技术评价左室心肌节段应变的可靠性[J].现代医学,2014,42(2):117-121.
[8] 田庄,方理刚,方全.超声心动图评价右心室功能的价值[J].心血管病学进展,2007(3):412-415.
[9] 孙轶,许迪,陆凤翔,等.组织多普勒成像测量Tei指数评价右心功能不全[J].东南大学学报:医学版,2008,27(1):17-19.
[10] 曹怡,杨慧,王燕,等.定量组织速度成像及组织追踪成像评价矽肺患者右心室收缩功能变化[J].中国临床医学,2014(5):572-574.
[11] KONG D,SHU X,PAN C,et al.Evaluation of right ventricular regional volume and systolic function in patients with pulmonary arterial hypertension using three-dimensional echocardiography[J].Echocardiography,2012,29(6):706-712.
[12] GRAPSA J,O'REGAN D P,PAVLOPOULOS H,et al.Right ventricular remodelling in pulmonary arterial hypertension with three-dimensional echocardiography:comparison with cardiac magnetic resonance imaging[J].Eur J Echocardiogr,2010,11(1):64-73.
[13] 覃小娟,谢明星,吕清,等.超声三维斑点追踪成像技术评价慢性心力衰竭患者左心室整体应变的初步研究[J].中华医学超声杂志:电子版,2010,7(8):1332-1337.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录