CAJ | 학술논문

目的探讨二维斑点追踪成像( 2D-STI)识别陈旧性心肌梗死左室心尖各段透壁程度的可行性.资料与方法对连续43例陈旧性心肌梗死患者行2D-STI及磁共振延迟强化成像(DE-MRI)随机同步盲法临床试验,各段分为透壁心肌梗死(TMI)组及非透壁(NTMI)组.结果与NTMI组相比,TMI组前壁舒张末厚度、收缩末径向应变[SR(ES)]、收缩末圆周应变[SC(ES)]、正向收缩期径向峰值应变(SR Peak P),收缩末纵向应变[SL (ES)]、收缩期圆周峰值应变(SC Peak)、最大负向纵向峰值应变(SL Peak G)、收缩期纵向峰值应变( SL Peak)及最大负向圆周峰值应变(SC Peak G)(均P＜0.05)；侧壁SC(ES)、SC PeakG、SC Peak及SL (ES)(均P＜0.05)；前间隔SL Peak、SL PeakG、SC Peak、SL (ES)、SC (ES)及SR (ES)(均P＜ 0.05)；后壁SR PeakP、SR (ES)及SL (ES)(均P＜ 0.05)；下壁SC PeakG、SC Peak及SC (ES)(均P＜0.01)；后间隔舒张末厚度(P＜0.01)绝对值均降低,甚至反向.ROC曲线分析舒张末厚度为判断前壁及后间隔透壁心梗最佳指标；SC (ES)为侧壁、SL Peak为前间隔、SR PeakP为后壁最佳指标；SC PeakG及SC Peak为下壁最佳指标.结论左室心尖段节段水平,多种应变指标可检出不同节段的透壁心肌梗死,但识别能力有异质性.
목적 탐토이유반점추종성상( 2D-STI)식별진구성심기경사좌실심첨각단투벽정도적가행성.자료여방법 대련속43례진구성심기경사환자행2D-STI급자공진연지강화성상(DE-MRI)수궤동보맹법림상시험,각단분위투벽심기경사(TMI)조급비투벽(NTMI)조.결과 여NTMI조상비,TMI조전벽서장말후도、수축말경향응변[SR(ES)]、수축말원주응변[SC(ES)]、정향수축기경향봉치응변(SR Peak P),수축말종향응변[SL (ES)]、수축기원주봉치응변(SC Peak)、최대부향종향봉치응변(SL Peak G)、수축기종향봉치응변( SL Peak)급최대부향원주봉치응변(SC Peak G)(균P＜0.05)；측벽SC(ES)、SC PeakG、SC Peak급SL (ES)(균P＜0.05)；전간격SL Peak、SL PeakG、SC Peak、SL (ES)、SC (ES)급SR (ES)(균P＜ 0.05)；후벽SR PeakP、SR (ES)급SL (ES)(균P＜ 0.05)；하벽SC PeakG、SC Peak급SC (ES)(균P＜0.01)；후간격서장말후도(P＜0.01)절대치균강저,심지반향.ROC곡선분석서장말후도위판단전벽급후간격투벽심경최가지표；SC (ES)위측벽、SL Peak위전간격、SR PeakP위후벽최가지표；SC PeakG급SC Peak위하벽최가지표.결론 좌실심첨단절단수평,다충응변지표가검출불동절단적투벽심기경사,단식별능력유이질성.