多巴酚丁胺负荷超声背向散射积分技术早期检测存活心肌的实验研究  

Experimental study on early detecting viable myocardium by dobutamine stress ultrasonic integrated backscatter technique

作　　者：袁霞萍[1] 王新房[1] 刘望彭[2] 谢明星[1] 杨娅[1] 吕清[1] 康春松[2] 

机构地区：[1]华中科技大学同济医学院协和医院超声科,武汉430022 [2]山西医科大学第一医院超声科

出　　处：《中华超声影像学杂志》2002年第9期553-556,共4页Chinese Journal of Ultrasonography

摘　　要：目的　探讨小剂量多巴酚丁胺应用于心肌背向散射积分 (IB)技术早期识别存活心肌的价值。方法　建立犬顿抑心肌 (A组 )和梗死心肌 (B组 )模型 ,分别获取左冠状动脉前降支 (LAD)结扎前、结扎后 30min及再灌注 5min、15min、30min和输注小剂量多巴酚丁胺后的左室乳头肌水平短轴观二维、M型和IB图像 ,观察周期变化幅度 (CVIB)、标化平均声像强度 (标化AII)和室壁增厚率 (WT)的动态变化。结果　A组于冠状动脉闭塞后 ,标化AII略升高 ,WT和CVIB则明显下降 ;再灌注后 ,标化AII很快恢复至基础水平 ,而WT和CVIB于再灌注 30min时尚未完全恢复到基础水平 ,分别为基础值的 6 2 .5 7%±18.18%和 6 7.5 0 %± 11.88%。B组标化AII的变化趋势与A组相似 ,而WT和CVIB于再灌注后无改善。再灌注 30min时 ,A、B两组CVIB的差异虽有显著性意义 (P =0 .0 2 1) ,但A组中仍有 3条犬的CVIB与B组交叉 ;输注多巴酚丁胺后A组局部WT增加的同时CVIB也明显增加 ,而B组无显著改善 ,两组差异具有显著性意义且无交叉值。结论　多巴酚丁胺应用于IB技术可以早期识别存活心肌 ,提高了IB技术检测存活心肌的准确性 ,具有潜在临床应用价值。Objective To investigate the value of early detecting viable myocardial by lower dose dobutamine applied in integrated backscatter (IB) technique.Methods Animal models of dogs of stunned myocardium (group A) and infracted myocardium (group B) were made. Two dimensional?M mode and IB images of left ventricular short axis view at the mid papillary muscle level were obtained at baseline, pre reperfusion and at 5 min, 15 min, 30 min after reperfusion and after lower dose dobutamine infusion. The dynamic changes of cyclic variation of integrated backscatter (CVIB)?standardized average image intensity (AII) and the ratio of wall thickening (WT) were measured at the corresponding examination time points. Results In group A, standardized AII was slightly increased, and both WT and CVIB were significantly decreased after LAD occluded. Standardized AII was rapidly recovered, but WT and CVIB did not reach the baseline after reperfusion 30 min, which the ratio to base were 62.57%± 18.18% and 67.50%± 11.88%, respectively. The change tendency of standardized AII of group B was similar to that of group A, and WT and CVIB had no improvement after reperfusion 30 min of group B. After reperfusion 30 min, CVIB in two groups had significance (P= 0.021) but there were three dogs of CVIB in group A were overlapping with that of group B. CVIB was significantly increased with the increase of regional WT in group A, but those of group B had no significant changes after dobutamine infusion.Conclusions Lower dose dobutamine stress echocardiography applying in IB technique can early identify viable myocardium and improve the accurate of detecting viable myocardium by IB technique and has potential clinical value.

关 键 词：多巴酚丁胺 负荷超声 背向散射积分 早期检测 存活心肌 实验研究 

分 类 号：R445.1[医药卫生—影像医学与核医学]