实时心肌声学造影在心肌微循环障碍诊断中的应用价值  

Application Value of Real-Time Myocardial Contrast Echocardiography in the Diagnosis of Myocardial Microcirculation Disorders

作　　者：茹翱 范晓华 潘丹丽 姚家芳 许海斌 顾高杨 Ru Ao;Fan Xiaohua;Pan Danli;Yao Jiafang;Xu Haibin;Gu Gaoyang(Department of Ultrasonography,The First Affiliated Hospital of Huzhou University(The First People's Hospital of Huzhou),Huzhou,Zhejiang 313000,China;Department of Cardiovascular Medicine,The First Affiliated Hospital of Huzhou University(The First People's Hospital of Huzhou),Huzhou,Zhejiang 313000,China)

机构地区：[1]湖州师范学院附属第一医院(湖州市第一人民医院)超声医学科,浙江省湖州市313000 [2]湖州师范学院附属第一医院(湖州市第一人民医院)心血管内科,浙江省湖州市313000

出　　处：《中国超声医学杂志》2024年第3期297-300,共4页Chinese Journal of Ultrasound in Medicine

基　　金：浙江省教育厅科研项目资助(No.Y202248444)。

摘　　要：目的 探讨实时心肌声学造影(RT-MCE)在心肌微循环障碍诊断中的应用价值。方法 收集60例经皮冠状动脉介入治疗(PCI)术后疑似心肌微循环障碍患者,根据冠脉造影结果,将35例心肌微循环障碍的患者设为障碍组,25例无心肌微循环障碍或术后未复发的患者设为对照组。比较两组超声造影图片与左心室心肌声学造影参数,采用受试者工作特征(ROC)曲线下面积(AUC)分析各参数的诊断价值,采用斯皮尔曼法分析其相关性。结果 实时心肌造影影像中前降支、回旋支、室壁瘤区域显示较明显,清晰显示节段较多;障碍组心肌峰值声学强度(A)、曲线上升平台期平均斜率(β)、再充盈平均速度(K)、局部心肌血流量(MBF)值均低于对照组(P<0.05);A、K、MBF诊断心肌微循环障碍的AUC分别为0.796、0.795、0.799;心肌微循环障碍与A、K、MBF值呈负相关(P<0.05)。结论 RT-MCE对心肌微循环障碍可能有较好的诊断价值,心肌微循环障碍与A、K、MBF值可能呈负相关。Objective To investigate the application value of real-time myocardial contrast echocardiography(RT-MCE) in the diagnosis of myocardial microcirculation disorders.Methods A total of 60 patients with suspected myocardial microcirculation disorder after percutaneous coronary intervention(PCI) were collected.According to the results of coronary angiography,35 patients with myocardial microcirculation disorder were assigned as the disorder group,and 25 patients without myocardial microcirculation disorder or postoperative recurrence were assigned as the control group.Left ventricular contrast echocardiography parameters were compared between the two groups.The area under the curve(AUC) of receiver operating characteristic(ROC) was used to analyze the diagnostic value of each parameter,and the correlation was analyzed by Spearman method.Results The anterior descending branch,circumflex branch and ventricular aneurysm area were more obvious in left ventricular image of real-time myocardial contrast echocardiography,and more segments were clearly shown.Myocardial peak acoustic intensity(A),mean slope of curve rising plateau(β),mean refill velocity(K) and local myocardial blood flow(MBF) in the disorder group were lower than those in the control group(P<0.05).The AUC values of A,K and MBF in diagnosis of myocardial microcirculation disorder were 0.796,0.795 and 0.799,respectively.Myocardial microcirculation disorder was negatively correlated with A,K and MBF values(P<0.05).Conclusions RT-MCE may have a better diagnostic value for myocardial microcirculation disorders,which may be negatively correlated with A,K and MBF values.

关 键 词：实时心肌声学造影 经皮冠状动脉介入治疗 心肌微循环障碍 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]