摘要
目的探讨应用基于二维斑点追踪显像(2D-STI)技术的自动功能成像(AFI)纵向应变预测可疑冠状动脉粥样硬化性心脏病(冠心病)患者冠状动脉左前降支(LAD)严重狭窄的价值。方法将92例可疑冠心病患者根据冠状动脉造影(CAG)结果分为2组,A组(LAD狭窄<70%)49例,B组(LAD狭窄≥70%)43例。采集心尖左心室长轴、心尖四腔和心尖两腔心切面二维灰阶动态图像。采用AFI软件自动测量左心室18节段收缩期纵向应变(LS)、左心室收缩期整体纵向应变(GLS)及左前降支支配区域纵向应变(TLS)。比较2组间各常规超声参数和二维纵向应变参数差异,绘制各参数预测LAD严重狭窄的ROC曲线。结果 2组常规超声参数差异均无统计学意义(P均>0.05),B组GLS及TLS均明显低于A组(P均<0.001),TLS和GLS预测LAD严重狭窄的曲线下面积(AUC)最大,分别为0.715和0.705,TLS和GLS预测LAD严重狭窄的截断值、敏感度、特异度分别为:-19.58%、63.3%、67.4%和-20.85%、74.4%、61.2%。结论基于2D-STI技术的AFI测量心肌纵向应变参数可用于预测可疑冠心病患者LAD严重狭窄,GLS较TLS敏感度高。
Objective To explore the value of automated function imaging(AFI)based on two-dimensional speckle tracking imaging(2 D-STI)technique longitudinal strain for predicting severe stenosis of left anterior descending(LAD)coronary artery in patients with suspected coronary heart disease(CHD).Methods Ninety-two patients with suspected CHD were divided into two groups according to the coronary angiography(CAG)results.There were 49 cases in group A(LAD stenosis rate<70%)and 43 cases in group B(LAD stenosis rate≥70%).The two-dimensional gray scale dynamic images were obtained in apical four-chamber view,apical two-chamber view and long axis of left ventricle(LV)view.Eighteen segments of LV longitudinal peak systolic strain,global longitudinal strain(GLS)and territorial longitudinal strain(TLS)supplied with LAD were measured with AFI software.The conventional ultrasonic parameters and the two-dimensional longitudinal strain parameters were compared between the two groups and ROC curve analysis of these parameters was used to predict LAD severe stenosis.Results There was no significant difference in the conventional ultrasonic parameters between the two groups(all P>0.05).The group B had lower GLS,TLS than group A(both P<0.001).GLS and TLS showed the highest area under ROC curve(0.715 and 0.705)for predicting LAD severe stenosis.The cut-off value,sensitivity and specificity for predicting LAD severe stenosis were-19.58%,63.3%,67.4%in TLS,and-20.85%,74.4%,61.2%in GLS respectively.Conclusion The longitudinal strain parameters measured with AFI based on 2 D-STI technique can be used to predict LAD severe stenosis in patients with CHD,and GLS is more sensitive than TLS.
引文
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