彩色室壁运动技术与多普勒组织成像联合应用诊断心肌梗塞室壁运动异常

目的：探讨彩色室壁运动技术（CK）与多普勒组织成像（DTI）联合应用对心肌梗塞局部室壁运动异常（RWMA）的诊断价值。 方法：应用CK和DTI技术对67例确诊为心肌梗塞患者和40例正常对照者的左室壁节段运动进行检测。CK指标为收缩期内心内膜位移（CK），DTI指标包括：收缩期波峰值（Vs），舒张早期波峰值（Ve），舒张晚期波峰值（Va）。 结果：心肌梗塞患者CK检测的室壁运动幅度及DTI检测的室壁沿长轴运动速度均减低，有梗塞节段室壁运动减低更明显，单独CK与DTI指标诊断室壁运动异常和判定梗塞节段的敏感度均较低，CK和DTI对RWMA的敏感度分别为85.07%，86.56%，CK和DTI对梗塞节段的敏感度分别为87.62%，85.33%，而CK与DTI指标相结合后，对RWMA的敏感性达99.51%，判定梗塞节段的敏感性达99.11%。 结论：CK和DTI联合应用能更准确地诊断心肌梗塞患者的局部室壁运动异常，判定梗塞节段。

Diagnosis of regional wall movement abnormalities in acute myocardial infarction with color kinesis and Doppler tissue imaging

Objective To explore the clinical values of color kinesis (CK) combined with Doppler tissue imaging (DTI) in detection of regional wall movement abnormalities(RWMA) in patients with myocardial infarction. Methods The left ventricular wall movements were measured by CK and DTI techniques in 67 patients with myocardial infarction and 40 normal control subjects. DTI indexes included peak velocity of systolic wave(Vs), peak velocity of early or late diastolic wave(Ve, Va). Results The amplitudes of left ventricular wall movement by CK and the left ventricular wall movement velocities by DTI were decreased significantly in patients with myocardial infarction. The amplitudes and velocities of myocardial infarction segments were decreased further. The sensitivities of CK and DTI indexes were low in the diagnosis of RWMA (85.00% and 86.56%) and identification of infarction segments (87.62% and 85.33%) when they were used singly. When CK indexes were used with DTI indexes, the sensitivity of RWMA was 99.51%, the sensitiveity identification of infarction segments was 99.11%. Conclusion The RWMA and myocardial infarction segments can be diagnosed correctly by CK combined with DTI in patients with myocardial infarction.