心肌声学造影评价心肌血流灌注与冠状动脉狭窄的关系  

Evaluation of the relation between myocardial perfusion and the severity of coronary artery stenosis by myocardial contrast echocardiography

作　　者：张少文[1] 董少红[2] 石丹[2] 翟丽华[2] 吴瑛[1] 

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518020

出　　处：《放射学实践》2004年第3期167-169,共3页Radiologic Practice

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 :前瞻性研究心肌声学造影 (MCE)评价冠心病局部心肌血流灌注与冠状动脉狭窄的关系。方法 :用间歇二次谐波、脉冲反转显像综合技术对 48例经冠状动脉造影检查证实的冠心病患者行静态MCE检查。采用 16段划分法 ,对心肌显影进行目测半定量计分 (MCS)分析。计分方法 :回声均匀性增强 ,显影时间≤ 90s为 1分 ;回声低淡不均匀 ,显影延时 ( >90s)为 0 .5分 ,充盈缺损为 0分。结果 :以冠状动脉造影冠状动脉直径狭窄≥ 5 0 %为诊断标准 ,MCE检出冠状动脉狭窄的符合率为 88%(k =0 .75 )。MCS与冠状动脉狭窄程度相关性差 (r =-0 .17)。结论 :MCE技术能较准确的预测冠状动脉狭窄 ,但心肌显影程度并非与冠状动脉狭窄程度一致 ,因除狭窄程度外 ,与狭窄的范围、侧支循环。Objective:To evaluate prospectively the relation between regional myocardial perfusion and the severity of coronary artery stenosis in coronary artery disease (CAD) by myocardial contrast echocardiography(MCE).Methods:48 patients with CAD 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 of left ventricular wall in 16 segments. MCS was graded as score 1,which required homogeneous opacification and myocardial contrast opacified time (MCOT) ≤90 second;score 0.5,patchy pattern and prolonged MCOT >90 second;score 0,no opacification.Results:The concordance between MCS and quantitative angiography was 88% ( k =0.75).MCS was poorly correlated with the severity of coronary artery stenosis ( r =-0.17).Conclusion:MCE with intermittent harmonic pulsed inversion imaging can accurately predict coronary artery stenosis with ≥50% of diameter.However,the severity of coronary artery stenosis is not the only factor affecting myocardial contrast intensity,but the contrast intensity is also affected by the extent of coronary artery atherosclerotic lesion,coronary collateral circulation and intermittent trigger time of MCE.

关 键 词：冠状动脉狭窄 心肌声学造影 心肌血流灌注 血管造影术 间歇二次谐波 脉冲反转显像 

分 类 号：R445.1[医药卫生—影像医学与核医学]