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目的探讨速度向量成像(velocity vectorimaging,VVI)技术评估原发性高血压患者的升主动脉壁运动特性的临床应用价值。方法应用Siemens Sequoia512超声诊断仪的速度向量成像技术对30例原发性高血压患者和30例正常对照组进行定量分析,测量升主动脉长轴上前壁各点的收缩期及舒张期最大纵向运动速度(Vs,Ve)、应变(Ssmax,Semax)及应变率(SRsmax,SRemax)。结果①原发性高血压患者升主动脉内径较正常对照组增宽,升主动脉前壁运动幅度小于对照组(P<0.05)。正常对照组升主动脉管壁运动同步协调,长轴切面上前壁各点向量幅度基本相等,收缩期达峰时间一致(P>0.05)。②升主动脉长轴前壁各点纵向速度曲线呈现为规律波群:收缩期为S波,舒张期为E波。原发性高血压患者收缩期S波、舒张期E波速度Vmax、应变Smax、应变率SRmax均小于正常对照组(P<0.05)。③原发性高血压患者升主动脉长轴前壁各点收缩期S波达峰时间较正常对照组提前,二者的差异具有统计学意义(P<0.05)。结论速度向量成像技术能直观准确显示升主动脉管壁的纵向运动协调特性,为临床了解高血压患者的大动脉弹性异常提供依据。
Objective To investigate the clinical value of velocity vector imaging (VVI) in assessing ascending aortic wall motion in patients with essential hypertension. Methods The velocity vector imaging technique of Siemens Sequoia 512 was used to quantitatively analyze 30 patients with essential hypertension and 30 normal controls to measure the systolic phase of the anterior wall of the ascending aorta and the maximum longitudinal Movement velocity (Vs, Ve), strain (Ssmax, Semax) and strain rate (SRsmax, SRemax). Results ① The diameter of the ascending aorta in patients with essential hypertension widened compared with the control group, and the amplitude of anterior ascending aorta was smaller than that of the control group (P <0.05). In normal control group, the motion of the ascending aorta wall was synchronized and the vectoral magnitudes of the anterior wall of the long axis section were almost the same, and the peak systolic time was the same (P> 0.05). ② The longitudinal velocity curve of each point on the anterior wall of the ascending aorta showed a regular wave group: systolic phase was S wave and diastolic phase was E wave. The systolic S wave, diastolic E wave velocity Vmax, strain Smax, and strain rate SRmax in patients with essential hypertension were significantly lower than those in the control group (P <0.05). (3) The S-wave peak time of systolic phase at each point of the ascending aorta long axis in patients with essential hypertension was earlier than that of the normal control group, the difference was statistically significant (P <0.05). Conclusion The velocity vector imaging technique can directly and accurately display the longitudinal motion coordination of the ascending aorta wall and provide a basis for clinical understanding of the abnormalities of the aorta in hypertensive patients.