心肌声学造影评价心肌梗塞后残余狭窄的临床应用  

Clinical Application of Myocardial Contrast Echocardiography in Detecting Residual Stenosis After Myocardial Infarction

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]深圳市第二人民医院心内科

出　　处：《中国超声医学杂志》2002年第7期540-542,共3页Chinese Journal of Ultrasound in Medicine

基　　金：深圳市医药卫生科技计划基金资助 (编号 1 9980 60 0 1 )

摘　　要：目的 :前瞻性评价心肌声学造影 (Myocardial Contrast Echocardiography,MCE)对心肌梗塞后残余狭窄的应用价值。方法 :用间歇二次谐波、脉冲反转显像综合技术对 36例心肌梗塞患者行静态 MCE检查。采用 16段划分法 ,对心肌显影进行目测半定量计分分析。计分方法 (MCS) :回声均匀性增强 ,显影时间≤ 90秒为 1分 ;回声低淡不均匀 ,显影延时 (>90秒 )为 0 .5分 ,充盈缺损为 0分。结果 :以冠脉造影梗塞支冠脉直径狭窄≥ 5 0 %为诊断标准 ,MCE检出残余狭窄的敏感性 88.6 % ,特异性 75 .0 % ,准确性 87.2 %。心肌灌注异常程度与冠脉残余狭窄程度无相关 ,r=0 .36。结论 :MCE技术能较准确的评估心肌梗塞相关冠脉残余狭窄 。Objective:To estimate prospectively clinical application of myocardial contrast echocardiography(MCE) in detecting residual stenosis of the infarct related artery after myocardial infarction(MI).Methods:Thirty six patients with MI underwent both MCE with intermittent harmonic pulsed inversion imaging following intravenous injection of Levovist and coronary angiography(CAG) within 3 days. Estimations of myocardial contrast score(MCS) were 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; 0, no opacification.Results:The sensitivity, specificity and accuracy of MCE in predicting ≥50% diameter residual stenosis of the infarct related artery after MI were 88 6%, 75 0% and 87 2% respectively.Conclusions:MCE with intermittent harmonic pulsed inversion imaging can accurately detect residual stenosis after MI. However, MCS does not correlate with the severity of residual stenosis of the infarct related artery after MI.

关 键 词：心肌梗塞 残余狭窄 心肌声学造影 心血管造影术 临床应用 

分 类 号：R445.1[医药卫生—影像医学与核医学]