心肌声学造影定量急性心肌梗塞后心肌血流量的实验研究  

Experimental study on quantitative measurement of myocardial blood flow after acute myocardial infarction by contrast echocardiography

作　　者：李清[1] 沈学东[1] 黄钢[1] 陈灏珠[1] 朱伟[1] 钱菊英[1] 姚瑞明[1] 

机构地区：[1]上海医科大学中山医院暨上海市心血管病研究所,200032

出　　处：《中华超声影像学杂志》1999年第5期308-310,共3页Chinese Journal of Ultrasonography

摘　　要：目的　评价心肌声学造影定量心肌梗塞心肌血流灌注的价值。方法　对６条犬急性心肌梗塞模型进行心肌声学造影， 采用自身对照的方法分析缺血区和非缺血区心肌显影时间－强度曲线各参数之比与心肌血流量的关系。结果　梗塞区时间－强度曲线各参数中， 曲线下面积（ＡＵＣ）和峰值强度（ＰＩ）与心肌相对血流量高度相关（ｒ＝ ０．９２和０．８４， Ｐ＜ ０．０１）， 与心肌绝对血流量相关性良好（ｒ＝ ０．７７和０．７１， Ｐ＜ ０．０１）。不同水平心肌血流量间的ＡＵＣ、ＰＩ均存在显著性差异（Ｐ均小于０．０１）， 且随着血流量的减少而呈下降趋势。三项时间指标与心肌绝对血流量无直接关系。结论　心肌造影时间－强度曲线参数中的曲线下面积和峰值强度可准确定量心肌梗塞后局部心肌血流量。Objective\ To evaluate the capability of myocardial contrast echocardiography (MCE) in quantitative measurement of myocardial perfusion. Methods\ Six open chest dogs were studied 3 hours after acute left circumflex coronary occlusion by means of non selective coronary contrast echocardiography. The sonicated 5% human albumin was used for MCE. Myocardial blood flow (MBF) was measured by radiolabeled microspheres. Background subtracted time intensity curves from MCE images in each segmental myocardium of the left ventricular short axis view were derived and quantified using an off line videodensitometric analysis system. Measurements of the curves included peak intensity (PI), area under the curve (AUC), half time of descent (T1/2d) or ascent (T1/2a) and time to peak intensity (Tp). The results were compared with concomitant MBF. Results\ An excellent correlation was obtained between the index of relative perfusion (the ratio of MBF in the hypoperfused area to the perfused area) and the ratios of AUC or PI in the hypoperfused area to the perfused area ( r =0.92 and 0.84 respectively, P <0.01). AUC and PI demonsrated a fair correlation with the absolute MBF ( r =0.77 and 0.71 respectively, P <0.01), and could directly reflect changes in MBF. However, the remaining time parameters failed to correlate. Conclusions\ Regional myocardial perfusion can be accurately quantified by background subtracted time intensity curves derived from MCE images. Thus, it may be possible in the future to quantitatively assess collateral perfusion with MCE during coronary occlusion.

关 键 词：超声心动描记术 造影剂 心肌梗塞 心肌血流量 

分 类 号：R542.22[医药卫生—心血管疾病] R540.45[医药卫生—内科学]