实时心肌超声造影与双核素同时采集法心肌显像检测冬眠心肌的对比研究  

Comparison of real-time myocardial contrast echocardiography and DISA-SPECT in dectecting hibernating myocardium

作　　者：李东野[1] 郝骥[1] 梁力[1] 李文华[1] 陈静[2] 任少阳[3] 潘德锋[1] 夏勇[1] 

机构地区：[1]徐州医学院心血管病研究所,徐州医学院附属医院心内科,221002 [2]徐州医学院心血管病研究所,徐州医学院附属医院心超声室,221002 [3]徐州医学院心血管病研究所,徐州医学院附属医院核医学科,221002

出　　处：《中华超声影像学杂志》2009年第5期389-392,共4页Chinese Journal of Ultrasonography

摘　　要：目的评价并比较实时心肌超声造影（RT—MCE）与双核素同时采集法心肌显像（DISA—SPECT）对冬眠心肌的检测价值。方法14例冠心病患者行RT—MCE、DISA—SPECT、冠状动脉造影检查和介入治疗所有狭窄病变均行完全血运重建。RT—MCE按美国超声心动图学会16节段划分法获得各运动异常节段显影，DISA-SPECT参照上述节段划分法获得各运动异常节段显影，用以评价冬眠心肌。图像分析均采用目测半定量法。术后1、3、6个月复查心脏超声，以冠脉血运重建后室壁节段收缩功能改善为判断冬眠心肌的金标准。结果RT—MCE和DISA—SPECT目测半定量法检测冬眠心肌的灵敏性、特异性、准确性分别为74．6％、91．7％、81．3％和93．3％、75．0％、86．2％；RT—MCE具有较高的特异性而DISA—SPECT具有较高的灵敏性。两种方法检测冬眠心肌的相关性良好。结论RT-MCE、DISA-SPECT检测冬眠心肌具有较高的临床价值，两种方法相关性好，分别在特异性和灵敏性方面具有优势。Objective To compare the accuracy of real time myocardial contrast echocardiography （RT-MCE） with DISA SPECT in detecting hibernating myocardium. Methods Fourteen hospitalized patients with regional wail motion abnormalities （RWMA） underwent RT-MCE, DISA-SPECT, coronary angiography and percutaneous coronary intervention（PCI）. Every left ventricular myocardial segment image was acquired and evaluated according 16-segment model of American Society of Echocardiography. The Motion of every segment was observed by echocardiography after 1,3,6 months. The gold standard is that the motion of ventrieular segment get better after PCI. The images of RT-MCE and DISA-SPECT were analyzed semi-quantitatively. Results The sensitivity,specificity,accuracy of RT-MCE and DISA SPECT in detecting hibernating myocardium were 74.6%,91.7%, 81.3% and 93. 3%,75.0%,86. 2%, respectively. RT-MCE had more value in specificity while DISA-SPECT had more value in sensitivity. The correlation between two methods was good in detecting hibernating myocardium. Conclusions RT-MCE and DISASPECT can be used as valuable methods to detect hibernating myocardium, the correlation between two methods is good and they have more value in specificity and sensitivity respectively.

关 键 词：超声心动描记术 微气泡 心肌顿抑 冠状动脉疾病 放射性核素显像 

分 类 号：R686[医药卫生—骨科学]