DTI诊断冠心病患者梗死缺血心肌的研究

目的运用多普勒组织成像(DTI)观测比较正常室壁心肌和梗死缺血心肌的运动变化,评估DTI对冠心病心肌梗死的诊断价值。方法对心肌梗死患者22例(前间壁梗死14例,下后壁梗死8例),健康人48人(对照组),于ap4cv、ap2cv、alax、pslax和pssax各切面,应用DTI观察正常室壁心肌与梗死缺血心肌运动的色彩变化及其DTI频谱曲线形态,并按左室壁16节段测量各室壁节段心肌运动曲线的速度指标(Sm、Em、MVGs、MVGe)。对DTI与二维(2D)超声检测梗死缺血心肌的诊断结果进行比较。结果(1)正常室壁心肌运动色彩均匀、鲜亮;梗死缺血心肌运动色彩较暗,频谱曲线S波较之正常低矮或紊乱。(2)DTI对心肌梗死患者室壁运动异常节段阳性检出率显著高于2D超声(前壁梗死组:43%vS25%;下壁梗死组:38%vs23%,均P<0.01)。结论DTI诊断冠心病心肌梗死优于2D超声。

Diagnoses of Myocardium in Myocardial Infarction or in Myocardial Ischemia of Patients with Coronary Heart Disease by Doppler Tissue Imaging

Objective To evaluate the diagnostic value of Doppler tissue imaging(DTI) for detection of infarction myocardium in coronary heart disease. Methods Ventricular wall motions of 22 patients with myocardial infarction (MI) (anterior-septum: 14; inferior-posterior: 8) and 48 health persons were examined. In six views [ap4cv, ap2cv, alax, pslax, pssax(CT, PM) ], the color coded by DTI of ventricular wall motion and the spectrum curve of ventricular wall motion of myocardium in MI or ischemia were observed and compared with those of normal myocardium. Having divided into 16 segments, velocities (Sm, Em, MVGs, MVGe) of all segments motion were measured or calculated by pulsed wave-DTI(PW-DTI). The diagnostic result of DTI for detection of myocardium in MI and myocardium in myocardial ischemia was compared with that of 2D echocardiography. Results (1)The color coded by DTI of ventricular wall motion was well-distributed and bright in healthy person and that of myocardium in MI or in myocardial ischemia was faint relatively. With myocardium in MI or in myocardial ischemia, the amplitude of S wave was lower than that of normal myocardium and the form of S wave was chaotic. (2)The total positive rate of DTI for detection of segments whose ventricular wall motion was abnormal was significantly larger than that of 2D echocardiography (anterior-septum: 43% vs 25%, P< 0.01; inferior-posterior : 38 % vs 23%, P<0.01). Conclusion The diadynamic value of DTI for detection of infarction myocardium in coronary heart disease is more excellent than that of 2D echocardiography.