中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2013年
10期
829-833
,共5页
王冬沫%田家玮%任敏%杜国庆
王鼕沫%田傢瑋%任敏%杜國慶
왕동말%전가위%임민%두국경
超声心动描记术%心肌病,扩张型%冠状动脉疾病%斑点追踪成像
超聲心動描記術%心肌病,擴張型%冠狀動脈疾病%斑點追蹤成像
초성심동묘기술%심기병,확장형%관상동맥질병%반점추종성상
Echocardiography%Cardiomyopathy,dilated%Coronary disease%Speckle tracking imaging
目的 探讨斑点追踪成像(STI)技术对扩张型心肌病(DCM)及缺血性心肌病(ICM)的鉴别诊断价值.方法 对40例DCM、32例ICM患者及30例对照组行超声心动图检查,记录左室各切面高帧频图像,应用STI技术测量心肌18个节段长轴纵向应变(Tls)、短轴圆周应变(Tcs)及径向应变(Trs)的达峰时间,同时计算出各峰值应变达峰时间的最大差(Ts-dif)及标准差(Ts-SD).比较两组间各参数差异,并采用受试者工作特征(ROC)曲线确定诊断的敏感性、特异性.结果 ICM组各节段Tls、Tcs及Trs的达峰时间的最大差(Ts-dif)及标准差(Ts-SD)均高于DCM组,差异有统计学意义(P＜0.05).通过ROC曲线得出Trs-dif及Trs-SD曲线下面积分别为0.920、0.946,以170 ms及53 ms为截断值诊断两种疾病的敏感性、特异性、准确性分别为87.5％、87.5％、87.5％及90.6％、90％、90.2％.结论 通过STI技术得到各应变指标的Ts-dif及Ts-SD鉴别DCM和ICM的敏感性和特异性很高,可以在二维图像的基础上进一步诊断两种疾病,其中以Trs-SD的诊断效力最大,为临床诊断提供了新的参考依据.
目的 探討斑點追蹤成像(STI)技術對擴張型心肌病(DCM)及缺血性心肌病(ICM)的鑒彆診斷價值.方法 對40例DCM、32例ICM患者及30例對照組行超聲心動圖檢查,記錄左室各切麵高幀頻圖像,應用STI技術測量心肌18箇節段長軸縱嚮應變(Tls)、短軸圓週應變(Tcs)及徑嚮應變(Trs)的達峰時間,同時計算齣各峰值應變達峰時間的最大差(Ts-dif)及標準差(Ts-SD).比較兩組間各參數差異,併採用受試者工作特徵(ROC)麯線確定診斷的敏感性、特異性.結果 ICM組各節段Tls、Tcs及Trs的達峰時間的最大差(Ts-dif)及標準差(Ts-SD)均高于DCM組,差異有統計學意義(P＜0.05).通過ROC麯線得齣Trs-dif及Trs-SD麯線下麵積分彆為0.920、0.946,以170 ms及53 ms為截斷值診斷兩種疾病的敏感性、特異性、準確性分彆為87.5％、87.5％、87.5％及90.6％、90％、90.2％.結論 通過STI技術得到各應變指標的Ts-dif及Ts-SD鑒彆DCM和ICM的敏感性和特異性很高,可以在二維圖像的基礎上進一步診斷兩種疾病,其中以Trs-SD的診斷效力最大,為臨床診斷提供瞭新的參攷依據.
목적 탐토반점추종성상(STI)기술대확장형심기병(DCM)급결혈성심기병(ICM)적감별진단개치.방법 대40례DCM、32례ICM환자급30례대조조행초성심동도검사,기록좌실각절면고정빈도상,응용STI기술측량심기18개절단장축종향응변(Tls)、단축원주응변(Tcs)급경향응변(Trs)적체봉시간,동시계산출각봉치응변체봉시간적최대차(Ts-dif)급표준차(Ts-SD).비교량조간각삼수차이,병채용수시자공작특정(ROC)곡선학정진단적민감성、특이성.결과 ICM조각절단Tls、Tcs급Trs적체봉시간적최대차(Ts-dif)급표준차(Ts-SD)균고우DCM조,차이유통계학의의(P＜0.05).통과ROC곡선득출Trs-dif급Trs-SD곡선하면적분별위0.920、0.946,이170 ms급53 ms위절단치진단량충질병적민감성、특이성、준학성분별위87.5％、87.5％、87.5％급90.6％、90％、90.2％.결론 통과STI기술득도각응변지표적Ts-dif급Ts-SD감별DCM화ICM적민감성화특이성흔고,가이재이유도상적기출상진일보진단량충질병,기중이Trs-SD적진단효력최대,위림상진단제공료신적삼고의거.
Objective To explore the differential diagnostic value of speckle-tracking imaging (STI) between dilated cardiomyopathy(DCM) and ischemic cardiomyopathy(ICM).Methods 40 DCM patients,32 ICM patients and 30 normal controls were enrolled for this study.Different views of high frame images of left ventricle were recorded.The time to peak radial strain,circumferential strain and longitudinal strain of 18 myocardial segments were measured by STI,and the maximum differential (Ts-dif) and the standard deviation(Ts-SD) of time to the peak strain were calculated.The left ventricular parameters measured by STI were compared between DCM and ICM,and the diagnostic sensitivity and specificity were investigated by the areas under the receiver operating characteristic (ROC) curves.Results Parameters of different segments of ICM were obviously higher than those of DCM (P ＜ 0.05),and there were significant differences between ICM and DCM.The areas under the ROC curves of Ts-dif and Ts-SD to radial strain were 0.920 and 0.946 respectively.At the cut off of 170 ms and 53 ms for diagnosing DCM and ICM,the sensitivity,specificity and accuracy were 87.5％,87.5％,87.5％ and 90.6％,90％,90.2％ respectively.Conclusions These strain parameters by STI,especially Ts-SD to peak strain can offer a new quantitative diagnostic method in distinguishing DCM from ICM.
