犬左前降支心外膜下层心肌冠状动脉分支角度的超声初步研究  

Preliminary study on left anterior descending branches angle of subepicardial coronary artery in the beagles using high-frequency transepicardial echocardiography

作　　者：傅英[1,2,3] 尹立雪[1,2] 李春梅[1,2] 龙滨[1,2] 陆景[1,2] 李文华[1,2] 李朝军[1,2] 

机构地区：[1]四川省医学科学院 [2]四川省人民医院超声医学研究所,成都610072 [3]川北医学院

出　　处：《中华医学超声杂志（电子版）》2011年第6期7-13,共7页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金资助项目(30670547)

摘　　要：目的应用高频二维灰阶超声结合彩色多普勒血流成像、心肌超声造影以及组织病理技术观察健康比格犬左冠状动脉前降支心外膜下层心肌及心肌内冠状动脉分支情况,通过测量分支点角度,利用流体力学原理以及心脏舒缩运动的特点分析其分支结构特点与冠状动脉循环的关系,深入认识心肌血流灌注的特点。方法 (1)8只健康比格犬,常规动物术前准备,开胸制作心包吊篮模型;(2)应用高频超声结合彩色多普勒血流成像和心肌超声造影经心外膜观察左冠状动脉前降支(LAD)、斜角支(OB)及其心肌内分支的连接和走行方向,尤其是心外膜下层心肌内分支,采集其长轴和短轴二维超声灰阶、心肌超声造影及彩色多普勒血流实时图像,并储存;(3)图像采集后,处死比格犬,取出心脏固定后游离左心室前壁,沿LAD、OB长轴及短轴制作大体标本、组织病理切片,分别在显微镜下观察心外膜冠状动脉及心肌内冠状动脉走行、连接,并摄影存图;(4)脱机应用photoshop图像分析软件分别沿所观察血管长轴和短轴的二维超声灰阶图上于LAD、OB上段(SSOB)和下段(ISOB)走行区域选取3支心外膜下层心肌内冠状动脉血管(SIMCA),测量其收缩末和舒张末与其上级主干血管夹角角度θ(θs、θd)。同时测量大体标本或组织病理切片上感兴趣区域(ROI)冠状动脉分支角度;(5)对所有进入分析的定量资料进行正态性和方差齐性检验,近似正态分布的定量资料以x-±s表示。LAD、OB上段和下段走行区域心外膜-心外膜下层心肌内冠状动脉分支角度三者之间比较使用单因素方差分析,同一节段舒张期和收缩期分支角度两两之间比较采用配对t检验,检验水准α=0.05,P<0.05差异有统计学意义。结果 (1)二维灰阶超声、彩色多普勒血流成像及心肌超声造影观察:比格犬左冠状动脉前降支心外膜下冠状动脉分支多以锐角"旋入"心外膜下层Objective To study the blood perfusion of myocardium in coronary circulation by evalu- ating the eruption angle of subepieardial coronary artery branches from beagle＇ s left anterior descending （LAD） coronary artery using transepicardial high-frequency echocardiography, Doppler flow imaging（ CD- FI）, myocardial contrast eehocardiography （MCE）, analyzing the relation between characteristic of branch and coronary circulation by principle of hydromechanics and characteristic of heart＇ special motion, and demonstrating its hemodynamics related anatomical characteristics with echocardiographic and patho-histologi- cal findings. Methods （ 1 ） Eight open-chest healthy female beagle models were used for the research. （2） Observating the connection, orientation and distribution of subepicardial coronary branches from LAD and its distal oblique branch （OB）into sub-epicardium or intra-myocardium using high-frequency transepicardial eeh- ocardiography ,2D gray scale imaging, color Doppler flow imaging （CDFI）＇ and myocardial contrast echocar- diography （MCE）. Then, the longitudinal and short-axis views of left ventricular anterior wall with epicardi- al and subepieardial coronary arteries were acquired in three successive cardiac cycles. （ 3 ） Beagles were ex- ecuted for euthanasia after eehocardiographie image collection and the heart were isolated and fixed in 6% formaldehyde solution for further patho-histological slice. （4） Observating the connection, orientation and distribution of subepicardial coronary branches from LAD and its distal oblique branch（OB） into sub-epicar- dium or intra-myocardium, and taking photos region of interesting （RO1）. （ 5 ） In 2D gray-scale, CDFI , MCE and photos of patho-histological slice , longitudinal and short axis views, the LAD, superior segments and inferior segments of oblique branch （SSOB ,ISOB） as well as three selected subepicardial intra-myocar- dium coronary artery（SIMCA） branches were displayed, and the eru

关 键 词：超声心动描记术 冠状动脉 分支 角度 心外膜下层心肌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]