经静脉心肌超声造影对犬冠状动脉阻断后心肌灌注动态变化的研究  

Study on dynamic changes of myocardial perfusion after coronary artery occluded with myocardial contrast echocardiography

作　　者：杨军[1] 郭启勇[1] 佟玉章[2] 喻晓娜[1] 

机构地区：[1]中国医科大学第二临床学院放射科,沈阳110003 [2]中国医科大学第一临床学院局解教研室,沈阳110003

出　　处：《中华超声影像学杂志》2004年第7期539-542,共4页Chinese Journal of Ultrasonography

摘　　要：目的　探讨自制超声造影剂经静脉心肌造影对犬冠状动脉阻断后不同时间灌注缺损面积对梗死面积评价的准确性。方法　应用超声处理仪振荡 5 %白蛋白和低分子右旋糖酐混合溶液 ,加入全氟丙烷 (C3 F8)气体自制超声造影剂 ;选择左心室乳头肌短轴观 ,对 12条犬于冠状动脉阻断前、阻断即刻和阻断后 1～ 4h进行经静脉心肌造影超声心动图研究。结果　阻断即刻的最大灌注缺损面积 (DA)占左心室乳头肌短轴观左心室壁心肌总面积百分比 (DA % )为 2 3 .0 1± 5 .3 3 ,阻断后 1～ 4h ,最大DA %与阻断即刻比较差异无显著性意义 (P >0 .0 5 )。阻断后最小DA %随时间发生变化 ,阻断即刻、阻断后 1、2、3、4h的最小DA %分别为 2 2 .19± 6.2 1,16.2 6± 3 .88,6.2 4± 2 .48,7.97± 2 .78和 8.80± 3 .45 (P <0 .0 1)。阻断后2～ 4h最小DA %与病理上梗死面积 (IA )占相应断面左心室心肌总面积百分比 (IA % )相关 ,r分别为0 .76,0 .80和 0 .85。结论　冠状动脉阻断后 ,心肌造影上最大灌注缺损面积无显著变化 ,而最小灌注缺损面积随时间变化 ,在阻断一定时间后 ,最小灌注缺损面积反映梗死面积。Objective To observe the dynamic changes of myocardial perfusion after the left anterior descending coronary artery(LAD) was occluded and to discuss the reliability of assessment of infarct area with myocardial contrast echocardiography(MCE) using intravenous injections of self-made contrast media after the coronary artery occlusion. Methods The contrast agent was made by sonocating 5% human albumin,Dextranum and C 3F 8. Twelve opened chest mongrel dogs underwent MCE when LAD was occluded,1,2,3,and 4 hours after LAD occlusion by intravenous injection of self-made contrast agent. The intermittent harmonic imaging was performed in the parasternal short-axis view at mid papillary muscle level. The maximum and minimum DA%s,which were the perfusion defect area(DA) percentage in the total left ventricular myocardium area,were measured and compared to the IA%s (IA: infarct area). Results The maximum DA% was 23.01 ± 5.33 at occlusion. There was no significant difference( P > 0.05 ) within 4 hours of occlusion. The minimum DA%s after occlusion were 22.19 ± 6.21 , 16.26 ± 3.88 , 6.24 ± 2.48 , 7.97 ± 2.78 and 8.80 ± 3.45 at the time instances of occlusion,1,2,3,and 4 hours after occlusion,respectively. The minimum DA%s were related to the infarcted area (IA) in the pathology within 2-4 hours of occlusion,with the values of r equal to 0.76 , 0.80 ,and 0.85 ,respectively. Conclusions Within the different time intervals after the LAD were occluded,the maximum DA%s have no significant difference,however the minimum DA%s change and relate to the IA% after 2 hours of occlusion.

关 键 词：经静脉心肌造影 犬 冠状动脉阻断 超声心动描记术 心肌梗死 心肌缺血 再灌注损伤 

分 类 号：R445.1[医药卫生—影像医学与核医学]