组织追踪成像技术与定量组织速度成像技术评价风湿性二尖瓣病变患者左心室局部功能的研究——附43例报告

组织多普勒成像技术测量二尖瓣环运动评价室间隔缺损患儿左心功能中文摘要研究目的室间隔缺损(ventricular septal defect, VSD)是小儿最常见的先天性心脏病之一。

超声心动图是临床上诊断先天性心脏病的最重要手段。

以往研究中，对室间隔缺损患儿的左心功能评价多采用二尖瓣血流图，但利用二尖瓣血流图评价左心室舒张功能时存在假性正常化，影响对左心功能正确的评价，从而影响临床早期病情判断及治疗。

随着医学超声影像学技术的不断发展，近年来多采用组织多普勒成像（Tissue Doppler imaging ,TDI）技术检测室间隔缺损患儿二尖瓣环运动波形，试图对室间隔缺损的患儿左心功能做出较准确的评价，并与常规二尖瓣血流多普勒频谱进行比较。

本研究通过比较传统多普勒与组织多普勒对室间隔缺损患儿的左心收缩、舒张功能的评价，旨在探讨TDI 对于室间隔缺损患儿左心室收缩和舒张功能的综合评定价值。

研究资料与方法实验组选取2012年3月至2012年8月间在安徽医科大学第二附属医院超声诊断科经超声心动图检查初次确诊单纯室间隔缺损患儿70例。

所有实验组患儿均无严重的肺动脉高压，亦无合并其他系统疾病，所有对象均为窦性心律。

所有实验组患儿按照室间隔缺损大小与主动脉根径比值分为三组：比值＞0.5为大型缺损（VSD大）；0.25≤比值≤0.5为中型缺损（VSD中）；比值＜0.25为小型缺损（VSD小）。

正常对照组选取同一时期进行健康体检的儿童25例，经严格病史询问、全面体检及实验室检查，排除心、脑、肺、肾、内分泌等系统疾病。

应用GE Vivid7彩色超声诊断仪，探头频率3.5-10MHz，对70例单纯室间隔缺损患儿及25例正常对照组儿童进行测量。

每一指标测定均取3-5个心动周期并取其平均值。

1）常规指标测量：取左室长轴切面，测定左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD），仪器自动显示左室射血分数（LVEF）3及左室短轴缩短率（LVFS）。

心脏影像技术在评价左心房及左心耳功能中的应用朱蔚;饶莉(综述)【摘要】Left atrial function may be divided into 3 phases:reservoir,conduit and contractile phase.The left atrial appendage plays a role in adjusting the pressure and volume of left atrial.The cardiac imaging techniques including echocadiography,cardiac computed tomo-graphy and cardiac magnetic resonance provide the accurate approach to asses the function.%左心房功能按时相可分为储存、管道和助力泵。

左心耳有调节左房压力和容积的作用。

超声心动图、心脏计算机断层扫描和心脏磁共振成像是评价左心房和左心耳的主要影像学技术。

现主要阐述各种心脏成像技术对左心房和左心耳功能的评价。

【期刊名称】《心血管病学进展》【年(卷),期】2016(037)005【总页数】4页(P472-475)【关键词】左心房;左心耳;功能;心脏影像技术【作者】朱蔚;饶莉(综述)【作者单位】四川大学华西医院心内科，四川成都610041;四川大学华西医院心内科，四川成都610041【正文语种】中文【中图分类】R445近年来，随着对心脏功能研究的不断深入，有关左心房及左心耳(left atrial appendage,LAA)功能的研究也越来越受关注。

左心房具有调节左心室充盈、维持每搏输出量的作用。

有研究发现左心房的大小及功能改变与心房颤动、脑卒中及猝死等心脑血管事件密切相关[1-3]。

而LAA有主动收缩舒张和分泌的功能，对于调节左心房压力和容积起着重要的作用。

Evaluation of real-time 3D-STI and MRI on ventricular systolic and diastolic function of T2DM patients/Fu Haijie, Wang Qi, Wang YueCT Room, Daqing Longnan Hospital, Daqing 163451, ChinaCorresponding author: [Abstract] Objective: T o explore the evaluation of real-time three-dimensional speckle tracking imaging (3D-STI) and magnetic resonance imaging (MRI) on ventricular systolic and diastolic function of patients with type 2 diabetes mellitus (T2DM). Methods: A total of 100 T2DM patients admitted to Daqing Longnan Hospital from January 2022 to June 2023 were selected, and they were divided into ≥50% group (62 patients) and <50% group (38 patients) based on the level of left ventricular ejection fraction (LVEF). The differences of 3D-STI and MRI parameters between different LVEF patients were compared, and the efficiencies of the 3D-STI parameter, MRI parameter and the combined data were also compared in diagnosing the cardiac insufficiency of T2DM patients. Results: The end-diastolic thickness of the interventricular septum (IVsd), left anterior descending branch (LAd), end-diastolic thickness of the posterior wall of the left ventricle (LVPWd), global area strain (GAS), global longitudinal strain (GLS), global circumferential strain (GCS), left ventricular systolic volume (ESV) and right ventricular systolic volume (EDV) in LVEF<50% group were respectively higher than those in LVEF ≥50% group. The velocities of peak A and E of mitral valve diastolic blood flow spectrum (E/A), global radial strain (GRS), stroke volume (SV), ejection fraction (EF) and cardiac output (CO) in LVEF<50% group were significantly lower than those in LVEF ≥50% group, and the differences were statistically significant (t =5.213, 4.778, 4.936, 5.863, 4.302, 5.057, 5.350, 5.072, 4.636, 4.963, 5.076, 4.898, 5.475, P <0.05), respectively. The binary logistic regression analysis showed that IVsd, LAd, LVPWd, GAS, GLS, GCS, ESV and EDV were risk factors for T2DM patients with cardiac insufficiency (OR =2.102, 1.286, 1.605, 1.311, 1.314, 1.324, 1.291, 1.063, P <0.05), respectively, and E/A, GRS, SV , EF and CO were protective factors for T2DM patients with cardiac insufficiency (OR =0.008, 0.823, 0.813, 1.850, 0.201, P <0.05). The area under curve (AUC) values of receiver operating characteristic (ROC) curves of MRI parameter (SV , EF, ESV , EDV and CO) and 3D-STI parameters (IVsd, LAd, LVPWd, E/A, GRS, GAS, GLS and GCS) were respectively 0.781, 0.743, 0.800 , 0.784, 0.777, 0.793, 0.770, 0.754, 0.745, 0.786, 0.836, 0.766, and 0.799 in diagnosing cardiac insufficiency of patients with T2DM. The MRI parameters and 3D-STI parameters were included into the Logistic regression model, and the AUC value of the combined data was 0.995 in diagnosing cardiac insufficiency of patients with T2DM, and the sensitivity and specificity of the combined data were [摘要] 目的：探究实时三维斑点追踪成像(3D-STI)及磁共振成像(MRI)对2型糖尿病(T2DM)患者心室舒缩功能的评价。

Advances in Clinical Medicine 临床医学进展, 2023, 13(2), 2176-2181 Published Online February 2023 in Hans. https:///journal/acm https:///10.12677/acm.2023.132305超声评估系统性红斑狼疮患者左心室功能的 研究进展王晓璇*，王志刚，李世玉#重庆医科大学附属第二医院超声科超声分子影像重庆市重点实验室，重庆收稿日期：2023年1月14日；录用日期：2023年2月8日；发布日期：2023年2月17日摘要 系统性红斑狼疮(SLE)是一种多系统性自身免疫疾病，病因复杂，心血管系统受累常见。

但由于该病临床体征及心脏损害超声表现无特异性，临床评估患者心脏早期损害具有挑战性。

超声检查具有实时、动态、便捷等优点，是临床评估心功能最常用的技术，其中最重要参数便是左心室功能。

本文对不同超声技术评估SLE 患者左心室功能的研究进展进行综述。

关键词系统性红斑狼疮，左心室功能，超声检查，综述Research Progress of Left Ventricular Function in Patients with Systemic Lupus Erythematosus Evaluated by UltrasoundXiaoxuan Wang *, Zhigang Wang, Shiyu Li #Chongqing Key Laboratory of Ultrasound Molecular Imaging, Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Received: Jan. 14th , 2023; accepted: Feb. 8th , 2023; published: Feb. 17th , 2023AbstractSystemic lupus erythematosus (SLE) is a multisystem autoimmune disease with complex etiology *第一作者。

二尖瓣环收缩期运动峰值速度定量评价左心室收缩功能【摘要】目的探讨组织多普勒成像(TDI)检测二尖瓣环运动对左心室收缩功能的评价作用。

方法以TDI技术检测心尖四腔切面二尖瓣前叶瓣环的收缩期运动峰值速度(Sm)，以M型超声左心室长轴切面测量射血分数(EF)，计算Sm与EF的相关性。

结果 Sm与EF呈正相关(P<0.01)。

结论 TDI技术测量Sm评价左心室收缩功能较EF更敏感、更快捷。

【关键词】多普勒组织成像;二尖瓣环;左心室;收缩功能Abstract:Objective To investigate the evaluative role of tissue Doppler imaging (TDI) on the left ventricular systolic function by detection of the mitral annular movement.Methods The systolic movement (Sm) peak velocity of mitral annular in the apical four-chamber view was detected by TDI， and the ejection fraction (EF) in the left ventricular long axis view were measured by M-mode echocardiography. The correlation between Sm and EF was analyzed.Results Sm was positively correlated with EF (P<0.01).Conclusion Sm detection by TDI is better and quicker than EF in evaluating left ventricular systolic function.Key words： tissue Doppler imaging; mitral annulus; left ventricle; systolic function组织多普勒成像(TDI)是新近发展起来的一项超声诊断技术，以低频滤波器弃去高频率、低振幅的血流信号，专门检测心肌组织反射回来的低频率、高振幅频移信号，可定量反映心肌运动的速度和方向。

·方法技术学·Cardiac MR tissue tracking technique for quantitativelyevaluating myocardial strain of cardiacamyloidosis patientsHE　Jiangkai1， CUI　Chen1， MA　Wei2， WANG　Zhi2， LIU　Jia1， LI　Wei1，ZHAO　Kai1， NAI　Rile1， XU　Shasha1， QIU　Jianxing1*（1.Department of Radiology，2.Department of Cardiovascular， PekingUniversity First Hospital， Beijing 100034， China）［Abstract］Objective　To observe the feasibility of cardiac MR tissue tracking （CMR-TT）technique for quantitatively evaluating myocardial strain of patients with myocardial amyloidosis （CA）.Methods　Cardiac MRI were collected from20 patients of immunoglobulin amyloid light-chain CA （AL-CA，group A），20 cases of transthyretin CA （ATTR-CA，group B） and 20 healthy subjects （group C）， and myocardial strain parameters were obtained using CMR-TT technique.Left ventricular cardiac function parameters were compared among 3 groups， so were strain parameters of each myocardial segment of left ventricle and global myocardium，including 3D longitudinal strain （LS），3D radial strain （RS）and 3D circumferential strain （CS）.Results　Compared with those in group C，significant differences of left ventricular cardiac function parameters were found in both group A and B （all P＜0.01），while no statistical difference was found between group A and B （all P＞0.05）. Except for apical segment RS （P=0.81）， strain parameters in group A and B were both lower than those in group C （all P＜0.01）， while no significant difference was detected between group A and B （all P＞0.05）.Conclusion　CMR-TT technique could be used to quantitatively evaluate left ventricular myocardial strain of CApatients.［Keywords］myocardium； amyloidosis； magnetic resonance imaging； tissue tracking techniqueDOI：10.13929/j.issn.1672-8475.2024.01.009心脏MR组织追踪技术定量评估心肌淀粉样变性患者心肌应变何江凯1，崔晨1，马为2，王智2，刘佳1，李玮1，赵凯1，奈日乐1，徐莎莎1，邱建星1*（1.北京大学第一医院医学影像科，2.心血管内科，北京 100034）［摘要］目的　观察利用心脏MR组织追踪（CMR-TT）技术定量评估心肌淀粉样变性（CA）患者心肌应变的可行性。

CDFI上岗证考试（正常心脏超声表现、后天获得性心脏病）模拟试卷2(题后含答案及解析)题型有：1. A1型题 2. X型题1．心尖区声窗可检测到的切面不包括A．四腔心切面B．五腔心切面C．二腔心切面D．三腔心切面E．右室流出道切面正确答案：E解析：心尖区声窗可检测到的切面包括：四腔心切面、五腔心切面、二腔心切面、三腔心切面、心尖冠状窦四腔切面。

右室流出道切面可于胸骨旁切面扫查。

知识模块：正常心脏超声表现2．下列测值不在收缩期的是A．右室壁厚度B．主动脉瓣环径C．主动脉窦部内径D．左心房前后径E．主肺动脉内径正确答案：A解析：右室壁厚度是在舒张末期测量右室前壁心外膜面至心内膜面的厚度。

知识模块：正常心脏超声表现3．下列结构都可测值于M型超声心动图心室波群，除外A．右室B．左室C．室间隔厚度D．左室后壁厚度E．右室流出道内径正确答案：E解析：心室波群为调节M型取样线通过二尖瓣前、后叶腱索水平，显示的解剖结构依次为胸壁、右心室前壁、右心室、室间隔、左室腔、二尖瓣腱索、左心室后壁；左、右心室腔径与室间隔厚度及左心室后壁厚度在此区测量。

知识模块：正常心脏超声表现4．左心室收缩功能常用评价方法不包括A．M型超声心动图B．多普勒超声心动图C．声学定量技术D．组织多普勒技术E．二维超声心动图正确答案：D解析：左心室收缩功能常用评价方法有：M型超声心动图、多普勒超声心动图、声学定量技术、二维超声心动图、实时三维超声心动图；组织多普勒技术为评价左室舒张功能的技术。

知识模块：正常心脏超声表现5．下列不属于DTI技术的是A．组织追踪显像B．斑点追踪成像C．定量组织速度显像D．组织同步显像E．心肌应变率显像正确答案：B解析：DTI是以多普勒原理为基础，通过特殊方法直接提取心肌运动所产生的多普勒频移信号进行分析、处理和彩色编码，再以速度、加速度和能量多普勒成像3种不同的成像模式对心肌运动进行定性和定量分析的一项超声显像新技术。