| 李燕,吕清,王新房,王静,丁尚伟,陈明,张静.实时心肌超声造影评价冠状动脉不同狭窄程度患者心肌血流灌注[J].中国医学影像技术,2008,24(12):1955~1958 |
| 实时心肌超声造影评价冠状动脉不同狭窄程度患者心肌血流灌注 |
| Myocardial perfusion in patients with different graded coronary stenosis by real-time myocardial contrast echocardiography |
| 投稿时间：2008-06-11 修订日期：2008-09-07 |
| DOI： |
| 中文关键词: 心肌 超声心动描记术 冠状动脉狭窄 灌流 |
| 英文关键词:Myocardium Echocardiography Coronary stenosis Perfusion |
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| 中文摘要: |
| 目的 探讨静息状态下经静脉实时心肌超声造影(RT-MCE)评价冠脉不同狭窄程度患者心肌血流灌注的临床价值。方法 根据冠状动脉(CA)造影结果,按CA狭窄程度将其所供应的心肌节段分为A组、B组及C组,其中C组再按有无冠状动脉侧支循环分成有侧支循环形成的C1组及无侧支循环形成的C2组。对25例冠心病患者及16例年龄相匹配的健康志愿者行RT-MCE,从MCE再灌注充盈曲线获得平台期峰值强度(A值)和曲线上升斜率(β值)分析心肌灌注。结果 定性分析:病例组中有271个心肌节段MCE表现为灌注良好,81个心肌节段MCE表现为低灌注。定量分析:①A组及C1组的A值、β值及A×β值与对照组相比,差异均无统计学意义(P>0.05);②B组及C2组的β值、A×β值明显低于对照组,与对照组相比(β值分别为0.67±0.57 vs 0.97±0.65,0.65±0.80 vs 0.97±0.65; A×β值分别为4.51±3.89 vs 6.86±5.61,3.18±3.10 vs 6.86±5.61, P<0.05)。③当无侧支循环开放时,β及A×β值均随着CA狭窄程度加重呈不同程度递减,侧支循环开放,可能会高估CA狭窄时的心肌血流灌注。结论 在静息状态下,RT-MCE可较好地发现冠状动脉狭窄程度>75％的心肌血流灌注异常。 |
| 英文摘要: |
| Objective To investigate the clinical evaluation on myocardial perfusion abnormalities caused by different graded coronary stenosis in quiescent condition using real-time myocardial contrast echocardiography (RT-MCE). Methods According to coronary angiography, the myocardial segments were governed by different degrees stenotic coronary arteries and were divided into A (50％-75％), B (76％-89％) and C (≥90％) group. C1 subgroup had collateral circulation of coronary artery, and C2 subgroup had no coronary collateral circulation. RT-MCE was performed in 25 cases with coronary artery diseases and 16 age-matched healthy subjects. Plateau videointensity (value A) and time to plateau (value β) of the replenishment curve from MCE were calculated for perfusion analysis. Results There were 271 myocardial segments with good myocardial perfusion and 81 myocardial segments with low perfusion in case group. Compared with control group, the values of A, β and A×β in A and C1 group were not significantly different (P>0.05), while compared with the control group, the values of β and A×β in B and C2 group were significantly lower (β: 0.67±0.57 vs 0.97±0.65, 0.65±0.80 vs 0.97±0.65; A×β: 4.51±3.89 vs 6.86±5.61, 3.18±3.10 vs 6.86±5.61, all P<0.05). The values of β and A×β decreased with stenosis degree, without coronary collateral circulation. The myocardial perfusion would be overestimated when the stenotic myocardium had coronary collateral circulation. Conclusion In quiescent condition, myocardial perfusion abnormalities can be detected by RT-MCE where coronary stenosis >75%. |
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