组织多普勒成像对显性预激综合征旁道定位的影响研究

目的评价多普勒组织成像（DTI）对显性预激综合征（WPW综合征）旁道定位的可行性和临床应用价值。方法术前用体表心电图初步预测31例显性WPW综合征患者旁道位置,再用DTI的加速度方式检查患者的心肌收缩顺序,并将心电图预测旁道位置及DTI所观察到的心室壁提前收缩部位分别与射频消融术中心内电生理检查标测的＂靶点＂比较。结果DTI定位总准确率为80.7%,左侧显性旁道准确率84.2%（16/19）,右侧为75.0%（9/12）,两侧定位准确率差异无统计学意义（P＆gt;0.05）;心电图定位完全符合率只有51.6%;正常组心室激动顺序为间隔心底段、游离壁及心尖部。结论DTI的加速度方式可用于检测心室正常或异常的除极过程,能对显性WPW综合征的旁道进行较准确的定位。

Location of the pre-excitation part in Wolff-Parkinson-White syndrome by Doppler tissue imagings

Objective To evaluate the feasibility of newly developed Doppler tissue imaging（DTI）for locating the early contraction sites in Wolff-Parkinson-White（WPW）syndrome.Methods The time-sequential changes in ventricular wall motion of 31 patients with WPW syndrome were examined by DTI.The pre-excitation site was represented as a red region appearing in the myocardium right after the δ wave of the electrocardiogram and confirmed by electrophysiology.Results Among 19 patients with left-sided accessory pathways,the early contractive sites were correctl identified by DTI in 16 patients,while the sites were determined by DTI in 9 of 12 patients with right-sided accessory pathways. There was no significant difference between the two groups （ P 〉 0.05）. Conclusion The DTI system is helpful to localize the accessory pathways and evaluate the results after radiofrequency ablation.