目的探讨实时三平面应变率成像技术评价左心房功能的可行性及其临床应用 价值方法选择40例正常人和30例肥厚性心肌病患者,应用实时三平面容积成像, 分别测量心房收缩前左心房容积!左心房最小容积和左心房最大容积,计算左心房 扩展指数!被动排空分数和主动排空分数,应用实时三平面应变率成像,分别测量- 左心房侧壁!房间隔!前壁!下壁和后壁收缩期!舒张早期和心房收缩期峰值应变 率,计算收缩期!舒张早期和心房收缩期左心房心肌平均峰值应变率(MSR)结果正 常人收缩期左心房心肌MSR与扩展指数呈正相关(二0.61,只D.01),舒张早期左心房 心肌MSR与被动排空分数呈负相关(二一0.67只0.01),心房收缩期左心房心肌MSR 与主动排空分数呈负相关(厂一0.78,只0.01)肥厚性心肌病患者收缩期左心房心 肌Ms尺与扩一展指数呈正相关(二0.62,只0.01),舒张早期左心房心肌MSR与被动排空 分数呈负相关(二一0.68,只0.01),心房收缩期左心房心肌MSR与主动排空分数呈负 相关(二一0.74,只0.01)肥厚性心肌病组的室间隔厚度明显厚于正常人组 (只0.05),两组的收缩期!舒张早期和心房收缩期左心房心肌MSR之间差别均具有统 计学意义(只0.沥)结论实时三平面应变率成像技术能够定量评价左心房局部心 肌功能,并能够反映肥厚性心肌病患者左心房局部功能的改变 研究生孙慧(心脏超声) 导师王志斌(教授) 关键词:实时三平面应变率成像;心房功能,左;正常人;心肌病,肥 厚性Feasibilitystudyonreal一timetriPjane!trainrateimagingfor quantitativeassessmentofleftatrialfunction Abstract ObjectiveToevaluatethefeasibjlityandcliniealvalueofreal一timetriPlanestrain rateimagingforthequantitativeassessmentofleftatrialfunction.MethodsTotally40 normalsubjeetsand30PatientswithhypertroPhiccardiomyoPathy(HCM)wereenrolled# Pre一atrialeontractionleftatrialvolume,minimalleftatrialvolumeandmaximalleft atrialvolumeweremeasuredusjngreal一timetriPlanevolumeimaging.玩ftatrjal exPansionindex(LAEI)leftatrialPassiveemPtyingfraetion(LAPEF)andleftatrial aetiveemPtyingfraction(LAAEF)wereealeulated.SystoliePeakstrainrate,early diastolicPeakstrainrateandlatediastolicPeakstrainrateweremeasuredusingreal一time triPlanestrainrateimaginginleftatrialIateral,sePtum,anterior,inferiorandPosterior walls.MeansystoliePeakstrainrate(MSRs),meanearlydiastoliePeakstraillrate (MSRe)andmeanlatediastoliepeakstrainrate(MSRa)wereealeulated.Theresults werecomPared.ResultsInnormalsubjects,MSRscorrelatedPositivelywithLAEI (r二0.61,P<0.01),MSReCorrelatedinverselywithLAPEF(r二一0.67,P<0.01),50did MSRawithLAAEF(r二一0.78,p<0.01).InPatientswithHCM,MSRseorrelated PositivelywithLAEI(r=0.62,P<0.01),MSReeorrelatedinverselywithLAPEF(r=一 0.68,P<0.01,50didMSRawithLAAEF(r==一0.74,P<0.01).Theinterventrieular sePtumthickerinHCMPatientsthaninnormalsubjectsgrouP伊<0.05),MSRs,MSRe andMSRaweresignifieantlydifferentbetweennormalsubjectsandPatientsWithHCM (P<0.05).ConelusionReal一ti,netriPlanestrainrateimagjng15feasibleforthe quantificationofleftatrialregionalmyoeardialfunetion.Leftatriallocaldysfunetion15 abletobedeteetedbyreal一timetriPla一zestrainrateimaginginPatientswithHCM. Postgraduatest一ldent:SunHui(UltrasoundDiagnosis) DireetedbyProfessor:WangZhibin(Professor) Keywords:Real一tillietriPlanestrainrateimaging;Atrialfunetion,left;Normal subjeets;CardiomyoPathy,hyPertroPI,ie 沁目录 弓}言#~#1 第1章资料与方法#/,4~2 1.1病例选择#1#..#2 1.2仪器#...#..,#0#2 1.3研究方法#~#...#~~...#2 1.3.1二维超声测量...#一2 1.3.2实时三平面容积成像~,#,..~#...,.#.2 1.3#3实时三平面应变率成像#~;#0#,......~~~#,#,..#.......,...........3 1.3.4超声图像获取和测量#...,..#~#-#3 1.4统计学处理~#~,....~....,#...3 第2章结果0#,..#0#/...4 2.1正常人组两种测量方法的比较4 2.2肥厚性心肌病组组两种测量方法的比较0..#~#4 2.3正常人组与肥厚性心肌病组的比较一,.#;,~#一4 第3章讨论0#,#0,..#000/#0#一5 3.1左心房的解剖和生理学基础#,#,..,卜#~#,..,5 3.21左心房的功能,#~#..~#,#...5 3.3超声评价左心房功能的指标~#,#一6 3.4实时三平面容积成像评价左心房功能....#一一6 3.5实时三平面应变率成像评价左心房功能-#,6 3.5.1实时三平面应变率成像评价正常人左心房功能....7 3.5.2实时三平面应变率成像评价肥厚性心肌病患者左心房功能#,.. 3#6研究的局限性,~,#4.......8结论/#0/00000#/00#0#/#00#000/#0#00000000#000#00