论文部分内容阅读
目的探讨应用速度向量成像(VVI)技术对胎儿房性心律失常时心肌结构力学及形变学影响的应变与应变率研究,评价胎儿心律失常时对心肌应激状态、运动传导就及功能的影像。方法对检出的77例胎儿心律失常(其中室上性心动过速(SVT)12例、65例为频发性房性早搏(PAC))进行VVI成像技术分析,检测心律失常时胎儿心肌运动速度向量变化及对应变与应变率影响,对照组80例心率正常胎儿。结果胎儿SVT 12例中7例持续发作48h者治疗前心室率250-310bpm,均合并心衰及出现水肿,VVI速度向量振幅明显降低,其应变与应变率明显低于对照组(P<0.01);阵发性SVT 5例VVI速度向量振幅一过性降低,心肌应变与应变率无变化;频发PAC组示早搏时速度向量振幅改变,且运动方向同步,心肌运动三维数据定量可显示早搏及代偿间期的三维模式,应变与应变率与对照组无差异(P>0.05)。结论VVI成像通过心律失常心肌结构力学变化解析胎儿心律失常,特别是对胎儿心动过速时的快速心率可进行实时动态分析。及应用M型扫描法确认心动周期使胎儿心肌应变与应变率分析成为可行。
OBJECTIVE To investigate the strain and strain rate of myocardial structural mechanics and degeneration affected by fetal ventricular arrhythmia using velocity vector imaging (VVI) technique and to evaluate the myocardial stress status, motor conduction and function during fetal arrhythmias. Methods Seventy-seven cases of fetal arrhythmia (including 12 cases of supraventricular tachycardia (SVT) and 65 cases of frequent atrial premature beats (PAC)) were analyzed by VVI imaging to detect fetal cardiac motion during arrhythmia Velocity vector changes and strain and strain rate, the control group, 80 cases of normal fetal heart rate. Results In 7 of 12 fetuses with SVT, the ventricular rate was 250-310bpm in 7 patients with continuous seizures. The heart rate and edema were all decreased. The amplitude of VVI velocity vector was significantly decreased and the strain and strain rate were significantly lower than those of the control group (P <0.01) ; 5 cases of paroxysmal SVT VVI velocity vector amplitude decreased transiently, myocardial strain and strain rate did not change; frequent PAC PAC premature beats when the velocity vector amplitude changes, and the direction of motion synchronization, three-dimensional myocardial motion data can be quantified to show premature beats and Three-dimensional mode of compensatory interval, strain and strain rate and the control group no difference (P> 0.05). Conclusion VVI imaging can analyze fetal cardiac arrhythmia through cardiac mechanics changes of cardiac arrhythmia, especially real-time dynamic analysis of fast heart rate during fetal tachycardia. And the application of M-scan to confirm the cardiac cycle so that fetal strain and strain rate analysis becomes feasible.