Wang Qiushuang, Huang Dangsheng, Zhang Liwei, Shen Dong, Ouyang Qiaohong, Duan Zhongxiang, An Xiuzhi, Zhang Meiqing, Zhang Chunhong, Yang Feifei, Zhi Guang
Department of Cardiology, First Affiliated Hospital of Chinese PLA General Hospital, Beijing, China.
Department of Nuclear Medicine, First Affiliated Hospital of Chinese PLA General Hospital, Beijing, China.
Echocardiography. 2015 Oct;32(10):1539-46. doi: 10.1111/echo.12901. Epub 2015 Feb 15.
To compare three-dimensional (3D) and two-dimensional (2D) speckle tracking echocardiography (STE) techniques in the assessment of left ventricular function and myocardial infarct size (MIS).
Thirty-two patients diagnosed with ST elevation myocardial infarction and 18 healthy control patients underwent 2D echocardiography, 3D echocardiography, and single photon emission computed tomography (SPECT). 3D left ventricular global area strain (GAS), 2D and 3D global longitudinal strain (GLS), global radial strain (GRS) as well as global circumferential strain (GCS) were analyzed to correlate with myocardial infarct size detected by SPECT. 2D and 3D left ventricular ejection fraction (LVEF) as well as 2D and 3D wall motion score index (WMSI) also were measured using conventional echocardiography.
The 2D-GLS values were significantly higher than that of 3D-GLS, while 2D-GCS and GRS were significantly lower than 3D-GCS and GRS, respectively. However, no significant differences in LVEF and WMSI could be observed between 2D and 3D echocardiography. Myocardial strain indices, LVEF, and WMSI using 2D and 3D echocardiography also had good correlations with MIS as measured by SPECT. ROC curve analysis showed that the 3D and 2D myocardial indices, LVEF, and WMSI could distinguish between small and large MIS, while 2D-GLS had the highest AUC.
The 2D and 3D myocardial strain indices correlated well with MIS by SPECT. Among them, the 2D-GLS showed the highest diagnostic value, while 3D-GRS and GCS had better diagnostic value than 2D-GRS and GCS.
比较三维（3D）和二维（2D）斑点追踪超声心动图（STE）技术在评估左心室功能和心肌梗死面积（MIS）方面的差异。
32例诊断为ST段抬高型心肌梗死的患者和18例健康对照者接受了二维超声心动图、三维超声心动图和单光子发射计算机断层扫描（SPECT）检查。分析三维左心室整体面积应变（GAS）、二维和三维整体纵向应变（GLS）、整体径向应变（GRS）以及整体圆周应变（GCS），并与SPECT检测的心肌梗死面积进行相关性分析。同时，使用传统超声心动图测量二维和三维左心室射血分数（LVEF）以及二维和三维室壁运动评分指数（WMSI）。
二维GLS值显著高于三维GLS值，而二维GCS和GRS分别显著低于三维GCS和GRS。然而，二维和三维超声心动图在LVEF和WMSI方面未观察到显著差异。二维和三维超声心动图测量的心肌应变指标、LVEF和WMSI与SPECT测量的MIS也具有良好的相关性。ROC曲线分析表明，三维和二维心肌指标、LVEF和WMSI能够区分小面积和大面积MIS，而二维GLS的曲线下面积（AUC）最高。
二维和三维心肌应变指标与SPECT测量的MIS具有良好的相关性。其中，二维GLS显示出最高的诊断价值，而三维GRS和GCS的诊断价值优于二维GRS和GCS。
