CAJ | 학술논문

目的：应用三维斑点追踪成像（3D-STI）技术定量评价小儿膜周部室间隔缺损（PmVSD）左心室局部收缩功能变化。方法：PmVSD小儿40例（PmVSD组），年龄、性别相匹配的对照组35例。采集左心室三维全容积图像，运用3D-STI技术测量2组对象收缩期左心室16节段的圆周、纵向、径向峰值应变，比较2组间各参数的差异性，并进一步分析其与左室射血分数、左室容量负荷参数的相关性。结果：PmVSD组左室各节段三个方向峰值应变测值大多数均较正常组增大，其中前、侧壁基底段和侧、后壁中间段的纵向峰值应变及侧壁、下间隔壁中间段的圆周峰值应变和侧壁、下间隔壁中间段及基底段的径向峰值应变差异有统计学意义（P＜0.05）；纵向、圆周、径向峰值应变均分别与左心室舒张末容积呈正相关。结论：3D-STI技术可敏感地检出PmVSD小儿左心室局部收缩功能的异常改变，具有一定的临床应用价值。
목적：응용삼유반점추종성상（3D-STI）기술정량평개소인막주부실간격결손（PmVSD）좌심실국부수축공능변화。방법：PmVSD소인40례（PmVSD조），년령、성별상필배적대조조35례。채집좌심실삼유전용적도상，운용3D-STI기술측량2조대상수축기좌심실16절단적원주、종향、경향봉치응변，비교2조간각삼수적차이성，병진일보분석기여좌실사혈분수、좌실용량부하삼수적상관성。결과：PmVSD조좌실각절단삼개방향봉치응변측치대다수균교정상조증대，기중전、측벽기저단화측、후벽중간단적종향봉치응변급측벽、하간격벽중간단적원주봉치응변화측벽、하간격벽중간단급기저단적경향봉치응변차이유통계학의의（P＜0.05）；종향、원주、경향봉치응변균분별여좌심실서장말용적정정상관。결론：3D-STI기술가민감지검출PmVSD소인좌심실국부수축공능적이상개변，구유일정적림상응용개치。
Objective: To evaluate regional left ventricular (LV) systolic function in pediatric with peri-membranous ventricular septal defect (PmVSD) using three-dimensional speckle tracking imaging (3D-STI). Methods: Transthoracic full-volume 3D images were obtained in 40 patients with PmVSD and 35 age-and sex-matched controls. The full-volume 3D datasets were recorded, 3D-STI analysis provided measures of peak circumferential, radial, and longitudinal strain in 16 LV segments (6 basal, 6 mid, and 4 apical), left ventricular end systolic and end diastolic volumes (LVESV and LVEDV) were automatic measured. The strain values were compared between the two groups. Correlation analysis between LVEDV, LVESV, LVEF and LV systolic strain values were made respectively.Results:Compared with the control group, multidirectional strains for almostly all segments strain values were higher in patients with PmVSD, especially the peak systolic longitudinal strain in LV anterior, lateral wall basal segments, lateral, posterior wall middle segments and the peak systolic circum-ferential strain in LV lateral, inferior-septum wall middle segments and peak systolic radial strain in LV inferior-septum, lateral wall middle segments and basal segments were signiifcantly higher than that of the control group (P<0.05). Among strain parameters, averege peak longitudinal strain exhibited the highest correlation with LVEDV. There were no signiifcant differences between two groups in LVEF.Conclusion: 3D-STI is able to con-ifrm regional LV dysfunction in pediatric patients with PmVSD.