能量多普勒组织成像和心肌超声造影定量心肌缺血的比较  

The Comparative Study of Doppler Power Tissue Imaging and Myocardial Contrast Echocardiography in Quantifying Myocardial Ischemia

作　　者：周京敏[1] 沈学东[1] 蔡乃绳[1] 张国辉[1] 朱伟[1] 陈灏珠[1] 

机构地区：[1]上海医科大学中山医院

出　　处：《中国超声医学杂志》1999年第5期321-324,共4页Chinese Journal of Ultrasound in Medicine

基　　金：上海市医学领先专业心内科重点学科资助

摘　　要：目的：比较能量多普勒组织成像（ＤＰＴＩ）定量室壁异常运动区面积和超声造影（ＭＣＥ）显示的心肌灌注缺损区面积的关系。方法：对８条急性缺血和心肌梗塞犬模型行ＤＰＴＩ和ＭＣＥ研究。仪器使用ＡＴＬＨＤＩ３００超声诊断仪和３．５ＭＨｚ超声探头。测量冠脉结扎后６小时左室壁异常运动区面积和心肌灌注缺损区面积。结果：冠脉结扎后６小时，８条犬均获满意的ＤＰＴＩ显示，２４个区域心肌活动消失，呈现紫黑色，和正常心肌间（金黄色）有明显的分界。ＤＰＴＩ显示的平均左室缺血区面积为１．８１±０．１７ｃｍ２，ＭＣＥ显示的平均左室缺血区面积为１．９１±０．１８ｃｍ２，二者无显著性差异（Ｐ＞０．０５），并高度相关（ｒ＝０．９９，Ｐ＜０．００１）。但该结果均大于病理切片上ＮＢＴ染色所显示的心肌梗塞面积（１．５３±０．１６ｃｍ２）（Ｐ均＜０．０１）。ＤＰＴＩ和ＭＣＥ测得的平均左室缺血区面积与病理实测值均高度相关（ＤＰＴＩ为ｒ＝０．９６，ＭＣＥ为ｒ＝０．９４，Ｐ＜０．０１）。结论：动物实验研究表明ＤＰＴＩ反映的室壁异常运动区面积和ＭＣＥ反映的心肌灌注缺损区面积没有差异。Objective:To compare the potential of Doppler power tissue imaging(DPTI)in quantifying the area of abnormal myocardial motion with that of myocardial contrast echocardiography(MCE)in quantifying the area of filling defect.Methods:Eight open chest canine models of myocardial infarction were established by ligating their coronary arteries.The area of abnormal left ventricular(LV)wall motion on DPTI (ATL HDI 3000 with a 3 5 MHz probe) and area of LV filling defect on MCE were measured 6 hours after the coronary ligation.Results:Excellent DPTI images were obtained in all dogs,24 ischemic segments were found to be akinetic,purple black in color,with a clear distinction from normal golden color myocardium.The mean abnormal LV motion area measured by DPTI(1 81±0 17cm 2)had no significant difference from the area of filling defect measured by MCE ( 1 91± 0 18cm 2)( P >0 05)and excellently correlated but area measurements were higher than that of pathological actual findings( P <0 001).Conclusion:This study revealed that the area of abnormal myocardial motion measured by DPTI agreed well with that of filling defect area measured by MCE.

关 键 词：心肌灌注 超声造影 心肌缺血 DPTI 多普勒成像 

分 类 号：R542.2[医药卫生—心血管疾病] R445.1[医药卫生—内科学]