组织同步成像技术对扩张型心肌病患者左心室心肌非同步运动的研究

目的研究扩张型心肌病(DCM)患者左心室心肌运动非同步性特征及其临床意义。方法采用组织同步成像(TSI)技术对30例DCM患者(DCM组)和30例健康人(对照组)的左心室心肌进行检测,获取左心室各节段心肌长轴方向的组织运动图像,测量左心室基底段、中间段心肌收缩达峰时间(Ts),分析左室12个节段Ts的标准差(Ts-SD)、Ts的最大值与最小值之差(Ts-dif)及TSI图特点。结果对照组左心室各节段心肌运动同步性较好,TSI图彩色编码多为均一分布的绿色,仅少数节段表现为浅黄色;DCM组各节段心肌同步运动消失,心肌彩色编码表现为绿-黄-红,明显不均。与对照组比较,DCM组编码为黄色或红色的节段数明显增多(P<0.05),左心室各节段Ts、Ts-SD及Ts-dif显著延长(P<0.05)。结论 TSI是一种无创伤性定量评价局部心肌Ts的新方法,是目前评价DCM患者左心室非同步运动的最佳方法。

A study on non-synchronous motion of left ventricular myocardium of patients with dilated cardiomyopathy using tissue synchronization imaging

Objective To study the non-synchronous characteristics of left ventricular myocardial motion of patients with dilated cardiomyopathy(DCM) and its clinical significance.Methods Tissue synchronization imaging(TSI) technology was employed to detect the left ventricular myocardium of 30 patients with DCM(DCM group) and 30 healthy people(control group),and to obtain the tissue motion images of each segment of left ventricular long axis.The time to peak systolic velocity(Ts) of basal and middle segment of left ventricle were measured.The Ts-standard deviation(Ts-SD),difference between maximum and minimum value of Ts(Ts-dif) and the characteristics of TSI image of 12 segments of left ventricle were analyzed.Results In control group,each segment of left ventricular myocardium showed good motion synchronization and was mostly color-coded by uniform distributed green,only minority was color-coded by pale yellow.In DCM group,myocardial synchronization motion of each segment disappeared and was color-coded significantly by non-uniform distributed green,yellow or red.Compared with the control group,yellow or red coded segments in DCM group were increased markedly,and Ts,Ts-SD and Ts-dif of each segment of left ventricular myocardium in this group were significantly prolonged(P<0.05).Conclusion TSI is a new method for quantitative evaluation of regional myocardial Ts and a best way to assess non-synchronous motion of left ventricular myocardium of patients with DCM.