间歇二次谐波、脉冲反转显像心肌声学造影评价冠心病的临床应用  

Clinical Application of Myocardial Contrast Echocardiography by Intermittent Harmonic Pulsed Inversion Imaging in Coronary Artery Disease

作　　者：张少文 吴胜楠 董少红 林钟文 梁旭 吴瑛 胡雪松[3] 

机构地区：[1]暨南大学医学院第二附属医院深圳市人民医院超声科,广东省深圳市518020 [2]暨南大学医学院第二附属医院深圳市人民医院心内科,广东省深圳市518020 [3]深圳市孙逸仙心血管医院心内科

出　　处：《中国循环杂志》2001年第2期126-128,共3页Chinese Circulation Journal

基　　金：深圳市医药卫生科技计划基金(编号199806001)

摘　　要：目的：评价间歇二次谐波、脉冲反转显像心肌声学造影（ＭＣＥ）对冠心病的诊断价值。 方法：经静脉ＭＣＥ，用半定量方法评估心肌血流灌注，参照冠状动脉（冠脉）造影检查技术对４８例冠心病（冠心病组）和２２例冠脉造影正常者（对照组）进行研究。ＭＣＥ用左心室１６段划分法进行心肌造影计分（ＭＣＳ）：回声均匀性增强，显影时间≤９０秒为１分；显影延时（＞９０秒），回声低淡不均匀为０．５分，缺损为０分。 结果：以冠脉直径狭窄≥５０％为标准，ＭＣＥ诊断冠心病的敏感性８５．９％，特异性ｇ９１．５％，阳性预测值９３．６％，阴性预测值８１．８％，准确性８８．２％。ＭＣＳ与冠脉狭窄程度无相关性（ｒ＝０．１７）。 结论：ＭＣＥ能准确地判断冠脉病变的部位，检出直径狭窄≥５０％的冠脉病变，并能反映心肌血流灌注，但其显影程度与冠脉狭窄程度无相关。Objective:To evaluate prospectively clinical application of myocardial contrast echocardiography (MCE) in coronary artery disease (CAD). Methods: Fourly-eight patients with CAD and 22 normal subjects received MCE, by intermittent harmonic, pulsed inversion imaging following intravenous injection of levovist,and coronary angiography(CAG). Estimation of myocardial contrast score(MCS) was made by visual analysis in 16-segments model of left ventricular walls. MCS was graded as 1 [homogeneous opacification normal and myocardial contrast opacified time (MCOT)≤90 second], 0. 5 (patchy pattern and prolonged MCOT>90 second)and 0 (no opacification). Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MCE in predicting≥50% coronary diameter stenosis were 85. 9 %, 91. 5 %, 93. 6 %, 8l. 8 % and 88. 2 % respectively. MCS was not correlated with the seventy of coronary artery stenosis (r=0. 17). Conclusions:MCE by intermittent harmonic,pulsed inversion imaging can accurately detect the positon of coronary artery stenosis, myocardial perfusion abnormalities and the presence of≥50% diameter stenosis. MCS is not consistent with the seventy of coronary artery stenosis.

关 键 词：冠状动脉疾病 心肌声学造影 心血管造影术 冠心病 间歇二次谐波 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]