经静脉注射Levovist心肌声学造影间隙显像评价心梗患者心肌存活性:与心脏核素的对比研究  

Detection of Myocardial Viability by Intermittent Contrast Echocardiography with Levovist Intravenous Bolus in Patients with Myocardial Infarction:Comparison With ^(201)TI SPECT

作　　者：吴雪英[1] 舒先红[1] 潘翠珍[1] 李清[1] 李文罡[1] 陈绍亮[1] 周仰仍 沙伟 沈学东[1] 陈灏珠[1] 

机构地区：[1]上海医科大学附属中山医院,上海市心血管病研究所,上海市200032 [2]中国安捷伦特公司临床医疗部 [3]德国先灵公司

出　　处：《中国超声医学杂志》2001年第1期29-32,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :本研究旨在评价经静脉注射 L evovist心肌声学造影间隙显像检测心梗患者梗塞区心肌存活性的价值。方法 :本研究对 2 5例临床诊断为陈旧性心梗患者心肌声学造影和核素心肌显像的节段心肌灌注进行比较。结果 :2 5例患者 40 0个节段中 ,声学造影和 2 0 1铊记分完全一致的有 2 71个节段 (6 8% ) ,与核素相差 1级的有 12 2个节段(30 % ) ,相差 2级的有 7个节段 (2 % ) ,Kappa=0 .5 38。心肌声学造影判断存活心肌与心脏核素的符合率为 81% ,Kappa=0 .5 2 1。敏感性和特异性分别为 90 %和 6 0 % ;阳性预测值、阴性预测值分别为 84%和 72 %。结论 :经静脉注射L evovist心肌声学造影检测心梗患者梗塞区心肌存活性能提供与心脏核素相似的信息。但在左室心尖部和前间壁的显示仍有待进一步提高。Objective:The purpose of this study was to evaluate the myocardial viability by intermittent myocardial contrast echocardiography(MCE)via intravenous injection of Levovist in patients with previous myocardial infarction.Methods:The results of segmental myocardial perfusion by MCE in twenty five patients with previous myocardial infarction were compared with those of thallium 201 single photon emission computed tomography(SPECT).Results:In 400 ventricular segments of 25 patients,complete concordance score between MCE and SPECT was found in 271 (68%) segments,122(30%)segments had 1 grade discordance,and 2 grade discordance was found in only 7(2%)segments,Kappa=0 538.The agreement between the two techniques in assessing myocardial viability in the infarct zone was 81%,Kappa=0 521.The sensitivity,specificity,positive predictive value and negative predictive value were 90%,60%,84% and 72% separately.Conclusions:This study shown that MCE with intravenous injection of Levovist provides similar information as SPECT in assessment of the viable area in patients with previous myocardial infarction.However,the imaging quality of the apex and anterior septum still needs to be further promoted.

关 键 词：心肌梗塞 心肌存活性 心肌声学造影 心脏核素显像 对比研究 

分 类 号：R445.1[医药卫生—影像医学与核医学]