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目的:探讨组织追踪技术(TTI)在儿童扩张型心肌病(DCM)左心收缩功能评价中的应用价值。方法:DCM患者14例,NYHA分级分为DCM A组(HYHAⅡ级)和DCM B组(HYHAⅢ-Ⅳ级),健康儿童12例为对照组。用GE Vivid 7彩色多普勒超声显像仪同步获取心尖四腔、左室两腔和左室长轴切面的三平面TTI动态图,分析左室TTI图及心肌收缩期向心尖方向的位移距离(Ds)。结果:①DCM组收缩期TTI图色阶较对照组减少。②DCM组左室各节段Ds较对照组显著降低,以DCM B组降低更显著(P<0.05);DCM B组部分病例Ds呈中间段>基底段>瓣环、部分室壁二尖瓣瓣环平均Ds小于基底段及中间段。③DCM组有4例18个心肌节段(25.00%)出现纵向收缩延迟,均来自DCM B组。④对照组、DCM A组及B组二尖瓣瓣环Ds与左室射血分数相关性好(r=0.74、0.80、0.82,P<0.01)。结论:TTI技术能快速、直观、无创评价局部及整体左心收缩功能,对儿童DCM患者同样适用。
Objective: To investigate the value of tissue tracking technique (TTI) in the assessment of left ventricular systolic function in children with dilated cardiomyopathy (DCM). Methods: Fourteen patients with DCM were divided into two groups: DCM A group (HYHAⅡ) and DCM B group (HYHAⅢ-Ⅳ), and healthy children (12 cases) as control group. Three-plane TTI dynamic images of apical four-chamber, two-chamber left ventricle and long-axis of left ventricle were simultaneously acquired by GE Vivid 7 color Doppler ultrasound imaging system. The left ventricular TTI and the displacement of apical direction of myocardial systole (Ds). Results: (1) The TTI pattern of DCM group decreased compared with the control group. (2) In the DCM group, the Ds of left ventricular in each group was significantly lower than that in the control group, and decreased more significantly in DCM group (P <0.05). In some patients in DCM group, Ds was in the middle segment> basal segment> The mean Ds of the rings is less than the basal and middle segments. In DCM group, there were 4 cases of 18 myocardial segments (25.00%) showed delayed longitudinal contraction, both from DCM B group. ④ In control group, there was a good correlation between Ds and left ventricular ejection fraction in DCM group A and group B (r = 0.74,0.80,0.82, P <0.01). Conclusion: The TTI technique can evaluate local and global left ventricular systolic function quickly, intuitively and noninvasively, and is also suitable for children with DCM.