CAJ | 학술논문

目的探讨三维斑点追踪技术（3D-STI）在评价左心室心肌应变中的应用价值与优势。方法采用二维斑点追踪技术（2D-STI）、3D-STI对30名健康青年志愿者进行心肌斑点追踪分析，比较两种方法获得的左心室心肌所有节段纵向、径向和圆周收缩期峰值应变值的大小、耗时及左心室不同水平收缩期峰值应变值的差异。结果使用3D-STI存储图像时间为（309.3±23.4）s，脱机分析时间为（305.5±11.2）s，使用2D-STI存储图像时间为（490.6±14.4）s，脱机分析时间为（1261.4±39.9）s，3D-STI耗时明显短于2D-STI，且差异有统计学意义（t=-21.81、69.94，P均＜0.01）。3D-STI所测左心室整体收缩期径向应变峰值为（48.59±7.68）%，2D-STI所测左心室整体收缩期径向应变峰值为（33.25±7.27）%，3D-STI测值较2D-STI大，且差异有统计学意义（t=9.16，P＜0.01）；3D-STI所测左心室整体收缩期纵向及圆周应变峰值分别为（-17.66±3.14）%、（-17.13±2.29）%，2D-STI所测左心室整体收缩期纵向及圆周应变峰值分别为（-21.35±2.46）%、（-21.97±3.84）%，3D-STI测值较2D-STI小，且差异均有统计学意义（t=5.33、5.99，P均＜0.01）。3D-STI示左心室径向、纵向及圆周收缩期峰值应变均在左心室中间部呈最大趋势，径向收缩期峰值应变在心尖部最小，圆周及纵向收缩期峰值应变则在基底部最小；2D-STI示左心室纵向、圆周收缩期峰值应变由基底部至心尖部有依次增大的趋势，径向收缩期峰值应变则与3D-STI规律相同。两种方法在两测试者间及同一测试者前后均值与差值于Bland-Altman图上呈一致性的变化趋势，具有较好的可重复性。结论3D-STI是一种方便、快速及可重复性较好的评价左心室心肌应变的新方法，具有潜在的临床应用价值。
목적탐토삼유반점추종기술（3D-STI）재평개좌심실심기응변중적응용개치여우세。방법채용이유반점추종기술（2D-STI）、3D-STI대30명건강청년지원자진행심기반점추종분석，비교량충방법획득적좌심실심기소유절단종향、경향화원주수축기봉치응변치적대소、모시급좌심실불동수평수축기봉치응변치적차이。결과사용3D-STI존저도상시간위（309.3±23.4）s，탈궤분석시간위（305.5±11.2）s，사용2D-STI존저도상시간위（490.6±14.4）s，탈궤분석시간위（1261.4±39.9）s，3D-STI모시명현단우2D-STI，차차이유통계학의의（t=-21.81、69.94，P균＜0.01）。3D-STI소측좌심실정체수축기경향응변봉치위（48.59±7.68）%，2D-STI소측좌심실정체수축기경향응변봉치위（33.25±7.27）%，3D-STI측치교2D-STI대，차차이유통계학의의（t=9.16，P＜0.01）；3D-STI소측좌심실정체수축기종향급원주응변봉치분별위（-17.66±3.14）%、（-17.13±2.29）%，2D-STI소측좌심실정체수축기종향급원주응변봉치분별위（-21.35±2.46）%、（-21.97±3.84）%，3D-STI측치교2D-STI소，차차이균유통계학의의（t=5.33、5.99，P균＜0.01）。3D-STI시좌심실경향、종향급원주수축기봉치응변균재좌심실중간부정최대추세，경향수축기봉치응변재심첨부최소，원주급종향수축기봉치응변칙재기저부최소；2D-STI시좌심실종향、원주수축기봉치응변유기저부지심첨부유의차증대적추세，경향수축기봉치응변칙여3D-STI규률상동。량충방법재량측시자간급동일측시자전후균치여차치우Bland-Altman도상정일치성적변화추세，구유교호적가중복성。결론3D-STI시일충방편、쾌속급가중복성교호적평개좌심실심기응변적신방법，구유잠재적림상응용개치。
Objective To investigate the value of three-dimensional speckle tracking imaging (3D-STI) in assessment of left ventricular (LV) strains. Methods Thirty healthy young adults examined by two-dimensional speckle tracking imaging (2D-STI) and 3D-STI. And the results of LV measurements were compared, which included mean peak systolic longitudinal strains, radial strains and circumferential strains. Also, the time consumption of these two methods was compared. Results The time needed for 3D-STI in acquisition and analysis of the images were (309.3±23.4)s, (305.5±11.2)s, while the time for 2D-STI were (490.6±14.4)s, (1261.4±39.9)s. The differences were signiifcant(t=-21.81, 69.94, both P<0.01). The global mean peak systolic radial strains was (48.59±7.68)%by 3D-STI and (33.25±7.27)%by 2D-STI. The difference was signiifcant(t=9.16, P<0.01). The global mean peak systolic longitudinal and circumferential strains were (-17.66±3.14)%, (-17.13±2.29)% by 3D-STI and (-21.35±2.46)%, (-21.97±3.84)% by 2D-STI. The differences were signiifcant(t=5.33, 5.99, both P < 0.01). The 3D-STI strains were different at different levels of LV. The longitudinal, circumferential and radial 3D-STI strains were largest at middle levels. However, 2D-STI strains didn′ t show such trend. Peak strains measured by 3D-STI and 2D-STI showed high inter-observer and intra-observer agreement in Bland-Altman chart. Conclusion 3D-STI is a novel, convenient and reproducible method to evaluate the strains of LV.