多普勒组织成像技术结合多巴酚丁胺负荷试验评价缺血后心肌存活状态  

Aassessing the postischemic myocardial condition by combination of Doppler tissue imaging and dobutamine stress echocardiography

作　　者：冀瑞平[1] 王新房[2] 刘望彭[1] 李治安[2] 刘莉[2] 

机构地区：[1]山西医科大学第一医院,太原030001 [2]武汉同济医科大学附属协和医院超声科

出　　处：《中华超声影像学杂志》2000年第9期562-565,共4页Chinese Journal of Ultrasonography

摘　　要：目的　探讨多普勒组织成像 (DTI)技术评价缺血后心肌存活状态的价值。方法　应用AcusonSequoiaC2 5 6彩色多普勒超声诊断系统 ,对冠脉结扎时间不同的犬心脏收缩活动进行观测 ,术后标本经氯化三苯四氮唑 (TTC)染色证实有无坏死。结果　A组 :心肌顿抑组实验犬 6条 ,冠脉结扎 15min ;B组 :心肌坏死组实验犬 6条 ,冠脉结扎 3～ 6h。基础状态测值两组无显著性差异 ;A组冠脉结扎 15min ,B组结扎 3h时进行取样测量 ,DTI指标中心肌速度阶差 (MVG)出现显著性差异 ,再灌注 15min后测定 ,两组比较EF值无显著性差异 ,而缺血室壁内膜收缩速度 (Vs)、内、外膜速度差值△V1及MVG均有显著性差异 (P <0 .0 1) ,应用多巴酚丁胺后 ,A组所测指标均高于B组 (P <0 .0 5 ) ,与基础状态相比 ,心内膜速度增长率△V2 在A组明显高于B组 (P <0 .0 0 1)。结论　DTI技术可实时定量反映缺血后心肌的室壁运动信息 ,与小剂量多巴酚丁胺负荷试验相结合 。Objective To evaluate the value of Doppler tissue imaging (DTI) combined with dobutamine stress echocardiography(DSE) in identifying postischemic myocardial condition. Methods Twelve mongrel dogs were studied in an open chest model of coronary occlusion of various durations followed by reperfusion and dobutamine administration by Acuson Sequoia C256 color Doppler imaging system. Postmortem triphenyltetrazolium chlorde (TTC) staining was used to identify myocardial necrosis. Results Six dogs underwent brief (15 min) occlusions and developed no necrosis (group A). The other six dogs underwent prolonged (3 6 h) occlusions and had infarctions. During occlusion (group A, 15 min; group B, 3 h), only myocardial velocity gradient (MVG) was different (P< 0.05 ) between the two groups. After releasing of occulusion, myocardial systolic wave (Vs), the difference of endocardial and epicardial velocity (△V 1) and MVG were different (P< 0.01 ) between the two groups. During dobutamine administration, the parameters of group A were significantly different from those of group B(P< 0.05 ).Conclusions DTI technique could be used to quantitate the postischemic myocardial wall motion in real time and could identify the viable myocardium sensitively and accurately when combined with DSE.

关 键 词：超声检查 多巴酚丁胺 心肌顿抑 心肌缺血 

分 类 号：R445.1[医药卫生—影像医学与核医学]