| 陈莹,马大钊,何河.三维斑点追踪超声心动图联合心肌灌注显像诊断心肌受累型疾病[J].中国介入影像与治疗学,2026,23(6):360-365 |
| 三维斑点追踪超声心动图联合心肌灌注显像诊断心肌受累型疾病 |
| Three-dimensional speckle tracking echocardiography combined with myocardial perfusion imaging for diagnosing myocardial involvement diseases |
| 投稿时间：2026-03-24 修订日期：2026-05-19 |
| DOI：10.13929/j.issn.1672-8475.2026.06.008 |
| 中文关键词: 心肌疾病 超声心动描记术 心肌灌注显像 |
| 英文关键词:cardiomyopathies echocardiography myocardial perfusion imaging |
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| 中文摘要: |
| 目的 观察三维斑点追踪超声心动图（3D-STE）联合心肌灌注显像（MPI）诊断心肌受累型疾病的价值。方法 回顾性纳入152例心肌受累型疾病患者（病例组），包括45例冠心病、42例心肌炎、38例扩张型心肌病及27例其他心肌病变并据此分为4个亚组；以同期30名健康志愿者为健康对照组（HC组）。比较组间及亚组间3D-STE及MPI参数；以心肌活检或临床综合诊断结果为参考标准，观察各单一参数及其联合诊断心肌受累型疾病的效能。结果 病例组左心室整体纵向应变（GLS）、整体圆周应变（GCS）、整体径向应变（GRS）及整体面积应变（GAS）均低于HC组（P均＜0.05）；其内各亚组间上述参数差异亦均有统计学意义（P均＜0.05）。病例组126例（126/152，82.89%）MPI阳性、灌注缺损占比18.65%±8.32%；HC组均为MPI阴性。病例组内各亚组间MPI阳性率、缺损占比及轻度缺损占比差异均有统计学意义（P均＜0.05）。GLS、GCS、GRS及GAS均为心肌受累型疾病的独立保护因素（P均＜0.05），MPI阳性为其独立危险因素（P＜0.05）。单一GLS、GCS、GRS、GAS及MPI诊断心肌受累型疾病的曲线下面积（AUC）分别为0.862、0.829、0.821、0.881及0.901，五者联合的AUC为0.932，高于各单一参数（P均＜0.05）且与诊断标准具有极高一致性（Kappa=0.892，P＜0.001）。结论 3D-STE联合MPI诊断心肌受累型疾病的效能极佳。 |
| 英文摘要: |
| Objective To observe the value of three-dimensional speckle tracking echocardiography （3D-STE） combined with myocardial perfusion imaging （MPI） for diagnosing myocardial involvement diseases. Methods Totally 152 patients with myocardial involvement diseases， including 45 cases of coronary heart disease， 42 of myocarditis， 38 of dilated cardiomyopathy and 27 of other myocardial lesions were retrospectively enrolled（case group） and divided into 4 relative subgroups，while 30 healthy controls （HC） were taken as HC group. 3D-STE and MPI parameters were compared between groups and among subgroups. Taken myocardial biopsy or clinical comprehensive diagnosis results as reference standards， the efficacy of each parameter alone and their combination for diagnosing myocardial involvement diseases were observed. Results The global longitudinal strain （GLS）， global circumferential strain （GCS）， global radial strain （GRS） and global area strain （GAS） of the left ventricle in case group were lower than those in HC group （all P＜0.05）， and significant differences of the above parameters were found among 4 subgroups in case group （all P＜0.05）. In case group， MPI positive was observed in 126 cases （126/152， 82.89%）， with the perfusion defect proportion of 18.65%±8.32%， while all HC were MPI negative. Significant differences of MPI positive rate， defect proportion and mild defect proportion were noticed among 4 subgroups in case group （all P＜0.05）. GLS， GCS， GRS and GAS were all independent protective factors of myocardial involvement diseases （all P＜0.05）， while MPI positive was an independent risk factor （P＜0.05）. The area under the curve （AUC） of GLS， GCS， GRS， GAS and MPI for diagnosing myocardial involvement diseases was 0.862， 0.829， 0.821， 0.881 and 0.901， respectively， and of their combination was 0.932， higher than that of each parameter alone （all P＜0.05） and highly consistent with reference standards （Kappa=0.892， P＜0.001）. Conclusion 3D-STE combined with MPI had excellent efficacy for diagnosing myocardial involvement diseases. |
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