摘要
目的 了解负荷DTI二尖瓣环舒张期波形改变对心肌缺血的提示意义。方法 利用DTI观测 104例冠状动脉造影(CA)患者的二尖瓣环舒张期 4个位点的e波与a波的比值在多巴酚丁胺应用前后的变化,并与CA结果进行比较。结果 基础状态下DTI二尖瓣环 4个取样点的e/a均<1. 0时,冠心病的检出率较高,而二尖瓣环 4个取样点的e/a均≥1.0时的冠脉病变率最低(P<0. 01);负荷条件下原本各点e/aann≥1. 0的一些病例中出现部分取样点的e/aann<1. 0改变,其冠脉病变率增高或有增高的趋势(P<0. 05),而试验前后维持e/aann≥1. 0波形的病例的冠脉病变率有下降的趋势。结论 负荷剂量下不同位点的e/aann发生变化使得DTI以e/aann<1. 0为指标提示冠心病的准确度、灵敏度、特异度、阳性预测值和阴性预测值和以e/aann≥1. 0为指标排除冠心病的准确度、特异度、阳性预测值均有所提高。
Objective To understand the meaning of changes of mitral annular dynamics during diastole in diagnosing myocardial ischemia under the conditions of stress Doppler tissue imaging (DTI). Methods DTI studies including e/a ann ratio of 104 patients, who had undergone coronary arteriography, were obtained from each of 4 mitral annular sites, as follows: inferoseptal and lateral sites from the apical 4 chamber view, anterior and inferior sites from the apical 2 chamber view. According to the sites of e/a ann ≥1.0 or <1.0 at rest, 104 cases were divided into 5 groups: groupⅠ, in which e/a ann ≥1.0 was shown at all the 4 sites; group Ⅱ, e/a ann ≥1.0 at 3 of the sites; group Ⅲ, e/a ann ≥1.0 was detected at 2 sites; group Ⅳ, there was only one site with e/a ann ≥1.0; group Ⅴ, e/a ann ratios at all the sites were <1.0. Then, the groups above were further divided into several subgroups according to changes of the sites with e/a ann ≥1.0 after the stress DTI. Results The highest rate of coronary artery disease (CAD) was found in group Ⅴ at rest, while the lowest rate of CAD in group Ⅰ ( P <0.01). A tendency to have a high incidence of CAD was also noticed in the cases in which the e/a ann ratios changed from ≥1.0 into <1.0 after the tress echocardiography. However, no matter whatever happened the e/a ann ratios after the stress test, there still was a high incidence of CAD in group Ⅴ. Conclusion As changes of e/a ann ratios at partial sites in some cases of CAD happened during the stress test, analysis of these changes could improve the efficacy of stress DTI in diagnosing myocardial ischemia.
出处
《中国医学影像技术》
CSCD
北大核心
2005年第2期194-198,共5页
Chinese Journal of Medical Imaging Technology
关键词
多普勒组织成像
负荷试验
二尖瓣
冠心病
心肌缺血
Doppler tissue imaging
Stress test
Mitral valve
Coronary artery disease
Myocardial ischemia
