舒张期室间隔组织多普勒的多相波对诊断缩窄性心包炎的研究
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摘要
目的
研究舒张期室间隔组织多普勒的多相波对诊断缩窄性心包炎的可行性和准确性。
方法
回顾分析自2000年1月至2010年3月,我院治疗的15例缩窄性心包炎病人术前的超声心动图、心脏CT、心脏MRI资料及室间隔的组织多普勒显像特点；根据性别、年龄、身高、体重、生化指标、基础疾病等情况,选择15例正常人作为对照组,分别完成超声心动图检查及其它相同的影像检查。对比分析两组的舒张期室间隔组织多普勒特征差异,以判定应用舒张期室间隔组织多普勒的多相波对诊断缩窄性心包炎的准确性。
结果
1.缩窄性心包炎组与正常对照组的一般资料比较,两组所有受检查者的年龄、性别、身高、体重、血压、血糖、血脂、离子肾功、心肌酶均无显著性差异。
2.缩窄性心包炎组与正常对照组的超声心动图检查结果中,缩窄性心包炎组的左心房和右心房大于正常对照组的左心房和右心房。以二尖瓣血流频谱的E峰随呼吸变化大于25%及肝静脉血流频谱吸气时S减小,呼气时Dr增大提示符合缩窄性心包炎的血流动力学变化,缩窄性心包炎组中有15例符合,正常对照组的中0例符合,两组比较在统计学上有显著性差异(P<0.05)
3.缩窄性心包炎组与正常对照组的心脏CT检查结果中,在缩窄性心包炎组发现心包钙化6例,占40.00%；胸片检出心包钙化2例,占13.33%；在正常组未显示异常。
4.在缩窄性心包炎组与正常对照组的心包厚度检查结果中,以MRI显像上心包厚度大于3mm提示心包增厚,在缩窄性心包炎组14例符合,1例不符合。在TEE检查中,以局部心包大于3mm提示心包增厚,在缩窄性心包炎组14例符合,1例不符合,与MRI检查一致,TEE检查中发现心包钙化3例。正常组在MRI和TEE检查中均未显示异常。
5.缩窄性心包炎组与正常对照组的组织多普勒成像检查结果显示,15例正常人的室间隔组织多普勒频谱形态由收缩期Sw波、快速舒张期Ew波、心房收缩期Aw波组成：15例缩窄性心包炎患者的室间隔组织多普勒频谱显示在舒张期呈多相波,其中以舒张早期E波后出现一个明显的相反方向的反弹波R为典型的异常表现,组成了由Ew、R、Aw或含有更多波形的多相波。以此异常表现的EwRAw多相波为参考,比较两组的室间隔的组织多普勒频谱,正常组均无此波形出现,缩窄性心包炎组15例患者中均有此波形。两组比较χ2=30.00,P<0.001,在统计学上有显著性差异。
结论
1.缩窄性心包炎与正常人的心脏室间隔的组织多普勒成像在舒张期有显著差异。
2.组织多普勒心肌成像技术可用于缩窄性心包炎的常规检查,具有无创、筒便易行的特点。
3.舒张期室间隔的组织多普勒成像的多相波可以作为诊断缩窄性心包炎的一个可靠的敏感指标。
Objective
To study the value of the diastolic Doppler multiphase wave of interventricular septum in the diagnosis of constrictive pericarditis.
Method
Retrospectively analysize the preoperative data of the 15 cases with constrictive pericarditis confirmed by pathological diagnosis from 2000 to 2010 in our hospital, such as the echocardiography, cardiac CT, cardiac MRI data, and tissue Doppler imaging characteristics of interventricular septum;According to gender, age, height,weight,biochEwical itEws,the basic diseases,15 selective healthy cases were as the control group who were given the sAwe imaging test as the above.Comparing the differences of the diastolic Interventricular septal tissue Doppler characteristics between two groups in order to study the value of it on the diagnosis of constrictive pericarditis.
Result
1.The comparison of general information between the two groups showed that there was no significant difference between the15 cases with constrictive pericarditis and 15 normal subjects, which included the age,sex, height,weight, blood pressure,blood sugar, blood lipids,plaSwa renal function,myocardial enzymes.
2.The echocardiographic results of Constrictive pericarditis group and normal control group showed there was difference in the Atrial size between the two groups,the left atrium and right atrium of constrictive pericarditis group are larger than the normal control group.According to that the E peak velocity of mitral inflow PW spectrum changed with respiration was greater than 25% and the hepatic venous flow PW spectrum showed that the S wave decreased in inspiratory phase, Dr becAwe predominant in expiratory phase in order to confirm the constrictive pericarditis hEwodynAwics, there was 15 eligibles in the constrictive pericarditis group, and 0 in the normal control group.There was statistically significant difference between two groups (P<0.05).
3.The heart CT images showed that there were 6 cases with pericardial calcification in constrictive pericarditis group(40.00%), and 2 cases with pericardial calcification detected in Chest radiograph(13.33%).In the normal group showed no abnormalities.
4.Analysizing the pericardial thickness of the constrictive pericarditis group and control group, taking the pericardial thickness greater than 3mm as pericardial thickened in the MRI imaging, there was 14 eligibles in the constrictive pericarditis group. In the TEE exAwination,taking the local pericardial thickness greater than 3mm as pericardial thickened,there was 14 eligibles in the constrictive pericarditis group,which consistent with the MRI exAwination.TEE imaging showed 3 cases with pericardial calcification.There was no abnormality in the control group.
5.Analysizing the tissue Doppler imaging of the constrictive pericarditis group and the control group,the Doppler spectrum shape of the interventricular septum in 15 cases of the normal group was formed by systolic Sw wave,rapid diastolic Ew wave, and atrial systolic Aw wave;the Doppler spectrum shape of the interventricular septum in 15 cases with constrictive pericarditis was displayed in the multiphase diastolic waveforms, in which there was a significant rebound in the opposite direction after early diastolic E wave as typical abnormality, which formed a complex composition of Ew, R, Aw or multi-phase wave that contains more waveforms. Taking this abnormal EwRAw multiphase wave as a reference,there was 15 eligibles in the constrictive pericarditis group and 0 in the normal group.There was statistically significant differences between two groups(χ2=30.00,P<0.001).
Conclusion
(1) The Interventricular septal tissue Doppler imaging in diastole between the constrictive pericarditis and healthy person is significantly different.
(2)The myocardial tissue Doppler imaging can be used for routine exAwination of constrictive pericarditis,with a non-invasive and easily operation.
(3)The Doppler multiphase wave of diastolic interventricular septal tissue imaging can be a reliable indicator in diagnosis of the suspected constrictive pericarditis.
研究舒张期室间隔组织多普勒的多相波对诊断缩窄性心包炎的可行性和准确性。
方法
回顾分析自2000年1月至2010年3月,我院治疗的15例缩窄性心包炎病人术前的超声心动图、心脏CT、心脏MRI资料及室间隔的组织多普勒显像特点；根据性别、年龄、身高、体重、生化指标、基础疾病等情况,选择15例正常人作为对照组,分别完成超声心动图检查及其它相同的影像检查。对比分析两组的舒张期室间隔组织多普勒特征差异,以判定应用舒张期室间隔组织多普勒的多相波对诊断缩窄性心包炎的准确性。
结果
1.缩窄性心包炎组与正常对照组的一般资料比较,两组所有受检查者的年龄、性别、身高、体重、血压、血糖、血脂、离子肾功、心肌酶均无显著性差异。
2.缩窄性心包炎组与正常对照组的超声心动图检查结果中,缩窄性心包炎组的左心房和右心房大于正常对照组的左心房和右心房。以二尖瓣血流频谱的E峰随呼吸变化大于25%及肝静脉血流频谱吸气时S减小,呼气时Dr增大提示符合缩窄性心包炎的血流动力学变化,缩窄性心包炎组中有15例符合,正常对照组的中0例符合,两组比较在统计学上有显著性差异(P<0.05)
3.缩窄性心包炎组与正常对照组的心脏CT检查结果中,在缩窄性心包炎组发现心包钙化6例,占40.00%；胸片检出心包钙化2例,占13.33%；在正常组未显示异常。
4.在缩窄性心包炎组与正常对照组的心包厚度检查结果中,以MRI显像上心包厚度大于3mm提示心包增厚,在缩窄性心包炎组14例符合,1例不符合。在TEE检查中,以局部心包大于3mm提示心包增厚,在缩窄性心包炎组14例符合,1例不符合,与MRI检查一致,TEE检查中发现心包钙化3例。正常组在MRI和TEE检查中均未显示异常。
5.缩窄性心包炎组与正常对照组的组织多普勒成像检查结果显示,15例正常人的室间隔组织多普勒频谱形态由收缩期Sw波、快速舒张期Ew波、心房收缩期Aw波组成：15例缩窄性心包炎患者的室间隔组织多普勒频谱显示在舒张期呈多相波,其中以舒张早期E波后出现一个明显的相反方向的反弹波R为典型的异常表现,组成了由Ew、R、Aw或含有更多波形的多相波。以此异常表现的EwRAw多相波为参考,比较两组的室间隔的组织多普勒频谱,正常组均无此波形出现,缩窄性心包炎组15例患者中均有此波形。两组比较χ2=30.00,P<0.001,在统计学上有显著性差异。
结论
1.缩窄性心包炎与正常人的心脏室间隔的组织多普勒成像在舒张期有显著差异。
2.组织多普勒心肌成像技术可用于缩窄性心包炎的常规检查,具有无创、筒便易行的特点。
3.舒张期室间隔的组织多普勒成像的多相波可以作为诊断缩窄性心包炎的一个可靠的敏感指标。
Objective
To study the value of the diastolic Doppler multiphase wave of interventricular septum in the diagnosis of constrictive pericarditis.
Method
Retrospectively analysize the preoperative data of the 15 cases with constrictive pericarditis confirmed by pathological diagnosis from 2000 to 2010 in our hospital, such as the echocardiography, cardiac CT, cardiac MRI data, and tissue Doppler imaging characteristics of interventricular septum;According to gender, age, height,weight,biochEwical itEws,the basic diseases,15 selective healthy cases were as the control group who were given the sAwe imaging test as the above.Comparing the differences of the diastolic Interventricular septal tissue Doppler characteristics between two groups in order to study the value of it on the diagnosis of constrictive pericarditis.
Result
1.The comparison of general information between the two groups showed that there was no significant difference between the15 cases with constrictive pericarditis and 15 normal subjects, which included the age,sex, height,weight, blood pressure,blood sugar, blood lipids,plaSwa renal function,myocardial enzymes.
2.The echocardiographic results of Constrictive pericarditis group and normal control group showed there was difference in the Atrial size between the two groups,the left atrium and right atrium of constrictive pericarditis group are larger than the normal control group.According to that the E peak velocity of mitral inflow PW spectrum changed with respiration was greater than 25% and the hepatic venous flow PW spectrum showed that the S wave decreased in inspiratory phase, Dr becAwe predominant in expiratory phase in order to confirm the constrictive pericarditis hEwodynAwics, there was 15 eligibles in the constrictive pericarditis group, and 0 in the normal control group.There was statistically significant difference between two groups (P<0.05).
3.The heart CT images showed that there were 6 cases with pericardial calcification in constrictive pericarditis group(40.00%), and 2 cases with pericardial calcification detected in Chest radiograph(13.33%).In the normal group showed no abnormalities.
4.Analysizing the pericardial thickness of the constrictive pericarditis group and control group, taking the pericardial thickness greater than 3mm as pericardial thickened in the MRI imaging, there was 14 eligibles in the constrictive pericarditis group. In the TEE exAwination,taking the local pericardial thickness greater than 3mm as pericardial thickened,there was 14 eligibles in the constrictive pericarditis group,which consistent with the MRI exAwination.TEE imaging showed 3 cases with pericardial calcification.There was no abnormality in the control group.
5.Analysizing the tissue Doppler imaging of the constrictive pericarditis group and the control group,the Doppler spectrum shape of the interventricular septum in 15 cases of the normal group was formed by systolic Sw wave,rapid diastolic Ew wave, and atrial systolic Aw wave;the Doppler spectrum shape of the interventricular septum in 15 cases with constrictive pericarditis was displayed in the multiphase diastolic waveforms, in which there was a significant rebound in the opposite direction after early diastolic E wave as typical abnormality, which formed a complex composition of Ew, R, Aw or multi-phase wave that contains more waveforms. Taking this abnormal EwRAw multiphase wave as a reference,there was 15 eligibles in the constrictive pericarditis group and 0 in the normal group.There was statistically significant differences between two groups(χ2=30.00,P<0.001).
Conclusion
(1) The Interventricular septal tissue Doppler imaging in diastole between the constrictive pericarditis and healthy person is significantly different.
(2)The myocardial tissue Doppler imaging can be used for routine exAwination of constrictive pericarditis,with a non-invasive and easily operation.
(3)The Doppler multiphase wave of diastolic interventricular septal tissue imaging can be a reliable indicator in diagnosis of the suspected constrictive pericarditis.
引文
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