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目的：定量评估致心律失常性右室心肌病（ARVC）患者右心室壁运动功能。方法应用斑点追踪成像技术测量26例ARVC患者、24例特发性右室室速(IRVT)患者及28例正常人的右室游离壁各节段心肌应变、应变率、速度及位移，分别记录基底段、中间段及心尖段纵向收缩期峰值应变(St)、收缩期峰值应变率(SrS)、收缩期峰值速度(Vs)及峰值位移(D)，比较不同实验组间及不同室壁节段间的差异。结果正常人右室游离壁各节段的Vs、D存在明显的梯度分布，基底部值最大，中间段次之，心尖部最低，St、SrS亦存在类似梯度，但除心尖段St外，差异无统计学意义。在IRVT及ARVC病人中，Vs、D的梯度分布依然存在。IRVT组与正常对照组比较，右室游离壁各节段St、SrS、Vs、D均无统计学差异。ARVC组各节段St、SrS均低于正常对照组 ARVC组右室游离壁中间段及心尖段St低于IRVT组。ROC(receiver operating characteristic )曲线表明，运用右室游离壁中间段应变值诊断ARVC，当取-23.01%为截断值时，诊断敏感性为83.3%，特异性为87.5%，若以中间段应变率-1.27为截断值时，诊断敏感性为83.3%，特异性为93.8%。若以右室游离壁中间段应变值鉴别A R V C与I R V T，当取-21.39%为截断值时，诊断敏感性为83.3%，特异性为100%。结论二维斑点追踪法应变率检查发现ARVC患者右室游离壁各节段运动减弱，选择合适的截断值，可以为ARVC的诊断与鉴别诊断提供帮助。“,”Objective: To assess right ventricular free wal move function in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) by speckle tracking imaging(STI) Methods: Peak myocardial systolic strain (St) , strain rate (SrS) , Peak systolic velocity(Vs) and displacement(D) were measured respectively in right ventricular free wal basal , mid and apical segment in 26 patients with ARVC, 24 patients with IRVT and 28 healthy volunteers by STI.Results: The values of St and SrS in al segments were lower in ARVC group than those in control group( P<0.05). The values of St in mid and apical segment were lower in ARVC group than those in IRVT group( P0.05). The receiver-operating characteristics(ROC) curves for St value of mid segment showed that the sensitivity and specificity for predicting ARVC was 83.3% and 87.5% , respectively, when the -23.01% was chosen as cut point of St. Meanwhile, the sensitivity and specificity for distinguish ARVC from IRVT was 83.3% and 100% respectively when the -21.39% was chosen as cut point of St.Conclusions: It shows a decreased move function of right ventricular free wal in patients with ARVC by speckle tracking imaging. An appropriate cut point value would make use for the diagnosis and differential diagnosis of ARVC.