Mor-Avi Victor, Lang Roberto M, Badano Luigi P, Belohlavek Marek, Cardim Nuno Miguel, Derumeaux Genevieve, Galderisi Maurizio, Marwick Thomas, Nagueh Sherif F, Sengupta Partho P, Sicari Rosa, Smiseth Otto A, Smulevitz Beverly, Takeuchi Masaaki, Thomas James D, Vannan Mani, Voigt Jens-Uwe, Zamorano Jose Luis
University of Chicago, Chicago, Illinois, USA.
Eur J Echocardiogr. 2011 Mar;12(3):167-205. doi: 10.1093/ejechocard/jer021.
Echocardiographic imaging is ideally suited for the evaluation of cardiac mechanics because of its intrinsically dynamic nature. Because for decades, echocardiography has been the only imaging modality that allows dynamic imaging of the heart, it is only natural that new, increasingly automated techniques for sophisticated analysis of cardiac mechanics have been driven by researchers and manufacturers of ultrasound imaging equipment. Several such techniques have emerged over the past decades to address the issue of reader's experience and inter-measurement variability in interpretation. Some were widely embraced by echocardiographers around the world and became part of the clinical routine, whereas others remained limited to research and exploration of new clinical applications. Two such techniques have dominated the research arena of echocardiography: (1) Doppler-based tissue velocity measurements, frequently referred to as tissue Doppler or myocardial Doppler, and (2) speckle tracking on the basis of displacement measurements. Both types of measurements lend themselves to the derivation of multiple parameters of myocardial function. The goal of this document is to focus on the currently available techniques that allow quantitative assessment of myocardial function via image-based analysis of local myocardial dynamics, including Doppler tissue imaging and speckle-tracking echocardiography, as well as integrated back- scatter analysis. This document describes the current and potential clinical applications of these techniques and their strengths and weaknesses, briefly surveys a selection of the relevant published literature while highlighting normal and abnormal findings in the context of different cardiovascular pathologies, and summarizes the unresolved issues, future research priorities, and recommended indications for clinical use.
由于其本质上的动态特性，超声心动图成像非常适合用于评估心脏力学。几十年来，超声心动图一直是唯一能够对心脏进行动态成像的成像方式，因此，超声成像设备的研究人员和制造商推动了用于心脏力学复杂分析的新型、日益自动化技术的发展，这是很自然的。在过去几十年中出现了几种这样的技术，以解决解读过程中读者经验和测量间变异性的问题。有些技术被世界各地的超声心动图专家广泛接受并成为临床常规的一部分，而其他技术则仅限于新临床应用的研究和探索。有两种这样的技术在超声心动图研究领域占据主导地位：（1）基于多普勒的组织速度测量，通常称为组织多普勒或心肌多普勒，以及（2）基于位移测量的散斑追踪。这两种测量类型都有助于推导心肌功能的多个参数。本文的目的是关注目前可用的技术，这些技术可通过对局部心肌动力学的基于图像的分析来定量评估心肌功能，包括多普勒组织成像和散斑追踪超声心动图，以及综合背向散射分析。本文描述了这些技术的当前和潜在临床应用及其优缺点，简要综述了一些相关的已发表文献，同时强调了在不同心血管病理情况下的正常和异常发现，并总结了未解决的问题、未来研究重点以及临床使用的推荐适应症。
