右美托咪定自控监护麻醉对眼鼻微创手术的影响

目的观察右美托咪定复合舒芬太尼自控监护麻醉用于局部麻醉下行眼鼻微创外科手术患者的效果和安全性。方法选择60例局部麻醉下行单眼泪囊开窗引流术的患者,随机分为D组(右美托咪定),DS组(右美托咪定+舒芬太尼),MF组(咪唑安定+舒芬太尼),n=20。观察并记录术晨(T0)、入室时(T1)、局部麻醉时(T2)、手术开始后10 min(T3)、开始后20 min(T4)、开始后30 min(T5)、术后30 min(T6)的平均动脉血压(MAP)、心率(HR)、脉搏血氧饱和度(SPO2)、呼吸频率(RR)、呼气末二氧化碳分压(PETCO2)、Ramsay镇静评分、鼻内窥镜术野质量评分(SESFQ)、手术时间(OT)和术中自控按压次数(CPT)。结果 3组患者T1时点MAP、HR均高于T0时点(P0.05),DS组患者T2、T3、T4、T5和T6时点的MAP、HR低于T0时点(P0.05),且低于D组和MS组同时间点的MAP、HR(P0.05),D组患者T3、T4、T5和T6时点的MAP低于MS组同时点的MAB(P0.05),且T3、T4点的MAP低于D组其他时点(P0.05),MS组患者T5和T6时点的HR、MAP明显高于T2、T3、T4时点(P0.01);MS组患者T2、T3、T4、T5和T6时点的RR低于T1时点及D、DS组同时点的RR(P0.05),PETCO2高于T1时点及D、DS组同时点的PETCO2(P0.05),MS组T2、T3和T4时点的Ramsay评分均大于D组、DS组同时点的Ramsay评分(P0.05),T5和T6时点的Ramsay评分均明显小于D组、DS组同时点的Ramsay评分(P0.01);DS组患者的CPT和SESFQ均明显少于D、MS组(P0.01),而D组的SESFQ评分低于MS组(P0.05)。结论右美托咪定复合舒芬太尼自控输注较自控输注右美托咪定或咪唑安定复合舒芬太尼单次给药可更快、更有效地发挥镇静、镇痛、降低血压效应,提供良好的手术视野、缩短手术时间,且对患者呼吸功能影响甚微。     

右美托咪啶复合咪达唑仑及舒芬太尼对下肢手术止血带反应的抑制作用

目的观察右美托咪啶复合咪达唑仑及舒芬太尼对下肢手术止血带反应的抑制作用。方法选择2017年9月至12月首都医科大学附属北京友谊医院收治的80例(年龄18～60岁,ASAⅠ～Ⅱ级)行下肢手术的骨科患者进行前瞻性研究。按照随机数字表法将患者分为4组:对照组(C组)、咪达唑仑+舒芬太尼组(M组),右美托咪啶组(D组)和右美托咪啶+咪达唑仑+舒芬太尼组(D+M组),每组各20例。C组常规行腰硬联合麻醉;M组在腰硬联合麻醉后给予咪达唑仑和舒芬太尼;D组在腰硬联合麻醉后给予右旋美托咪定;D+M组在腰硬联合麻醉后给予右旋美托咪定复合咪达唑仑、舒芬太尼。分别记录患者止血带充气前(T1),止血带充气后1 min(T2),止血带放气前(T3),止血带放气后1 min(T4)的各个时间点的平均动脉压(MAP)和心率(HR),观察不良反应发生情况。结果与T1时间点相比,4组患者在T2时间点的MAP和HR均无明显变化(P0.05)。与T3时间点相比,在T4时间点,C组、M组和D组患者的MAP明显降低,HR明显增加(P0.05),而D+M组的MAP和HR则无明显变化(P0.05)。所有患者中C组(3例)和M组(2例)患者出现收缩压降低,D组(2例)患者出现心率降低,C组(4例),M组(1例),D组(3例)患者出现紧张不适。结论右美托咪啶复合咪达唑仑、舒芬太尼有助于维持骨科下肢手术使用止血带患者的血流动力学平稳。     

羟考酮联合右美托咪定在喉癌气管切开术中的应用

目的观察羟考酮联合右美托咪定在喉癌术前气管切开术中的麻醉效果和安全性。方法因喉癌手术拟在我院局麻下行气管切开的患者42例,随机数字表法分为羟考酮组和舒芬太尼组各21例。两组局麻前均泵入右美托咪定0.5μg/kg(10 min泵完),羟考酮组给予0.1 mg/kg羟考酮,舒芬太尼组给予等效剂量舒芬太尼0.1μg/kg,观察给药前(T0)、切皮时(T1)、气管内注药时(T2)、气管切开插入导管时(T3)的平均动脉压(MAP)、心率(HR)、氧饱和度(SPO2),呛咳、呼吸抑制、躁动发生情况;评估患者耐受程度,并随访患者对气管切开过程的不良回忆及VAS评分。结果与舒芬太尼组相比,羟考酮组T2、T3时点MAP、HR升高幅度更小,T3时点SPO2下降程度更小(P0.05),患者呛咳发生少,耐受程度高,术后不良记忆少,疼痛评分低(P0.05)。结论羟考酮联合右美托咪定可以安全有效用于喉癌术前气管切开的镇静镇痛,与舒芬太尼相比麻醉效果更好,患者循环更稳定,舒适度更高。     

舒芬太尼复合右美托咪定在脑外科手术患者全麻诱导期间对患者血流动力学的影响

目的探讨舒芬太尼复合右美托咪定在脑外科手术患者全麻诱导期间对患者血流动力学的影响。方法选取我院2016年5月～2018年10月收治的脑外科手术患者97例,均采取全身麻醉处理,依据麻醉诱导方案不同分为对照组48例和观察组49例。对照组采取舒芬太尼麻醉,观察组采取舒芬太尼复合右美托咪定麻醉,观察比较两组麻醉诱导前(T_0)、插管时(T_1)、插管后10min(T_2)、插管后20min(T_3)及手术结束即刻(T_4)时平均动脉压(MAP)、血氧饱和度(SpO_2)、心率(HR),比较两组麻醉阻滞起效用时、阻滞维持用时。结果两组T_0、T_1、T_2、T_3、T_4时SpO_2比较,差异无统计学意义(P0.05);两组T_0、T_1、T_4时MAP、HR比较,差异无统计学意义(P0.05),观察组T_2、T_3时MAP、HR均低于对照组,差异有统计学意义(P0.05);观察组麻醉阻滞起效用时较对照组短,麻醉阻滞维持用时较对照组长,差异有统计学意义(P0.05)。结论脑外科手术患者采取舒芬太尼+右美托咪定麻醉,效果确切,可确保全麻诱导期间血流动力学平稳。     

右美托咪定用于无痛纤支镜检查的效果评价

目的观察评价右美托咪定应用于无痛纤支镜的麻醉效果。方法接受纤支镜检查的患者60例,采用单盲法设计随机对照试验,采用随机数字表法将研究对象分为A组(舒芬太尼+丙泊酚),B组(右美托咪定+舒芬太尼+丙泊酚)各30例。A组患者在表面麻醉的基础上依次给予舒芬太尼0.15μg/kg和丙泊酚2 mg/kg。B组在10 min泵注完毕右美托咪定0.5μg/kg,以0.4μg/(kg·h)维持,再按照A组给药。观察患者入室时(T1)、开始检查纤支镜抵达声门时(T2)、纤支镜经过气管隆突时(T3)、检查完成时(T4)、检查完成后10 min(T5)血流动力学相关指标,血清炎症因子和不良反应发生率。结果与A组比较,B组T2时HR指标显著降低(P0.05);T3、T4时MAP、HR指标降低(P0.05);T3时Sp O2指标增高(P0.05);T3、T4、T5时RR指标增高(P0.05);B组患者检查后除IL-10外各炎症因子指标均降低(P0.05);B组患者检查后不良反应发生率显著低于A组(P0.05)。结论右美托咪定用于无痛纤支镜检查的麻醉更能稳定术中血流动力学的改变,降低炎症因子的表达和不良反应发生率,值得推广。     

右美托咪定和瑞芬太尼在肝癌患者局部射频消融介入手术中的应用效果比较

[目的]对比分析右美托咪定和瑞芬太尼在原发性肝癌(PLC)局部射频消融(RFA)介入手术患者中的应用效果.[方法]本院收治的PLC患者62例,随机患者分为右美托咪定组和瑞芬太尼组,每组31例.记录患者进入手术室(T0)、穿刺时(T1)、射频消融开始后15 min(T2)、射频消融结束退针时(T3)和患者苏醒时(T4)的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)和脉搏血氧饱和度(SpO2).比较两组各种药物用量和麻醉效果,两组术中及术后麻醉相关不良事件的发生情况.[结果]在T2时间点,右美托咪定组MAP、HR和RR水平均显著高于瑞芬太尼组,且两组之间相比较差异均有显著性(P<0.05),其余时间点,两组MAP、HR、RR和SpO2比较差异均无显著性(P>0.05).术中右美托咪定组使用右美托咪定量为(65.9±13.5)μg,瑞芬太尼组使用瑞芬太尼量为(398.6±89.5)μg.右美托咪定组舒芬太尼用量为(20.5±10.3)μg,显著低于瑞芬太尼组的(32.9±15.6)μg,两组之间相比较差异有显著性(P<0.05).右美托咪定组麻醉效果为优的比例为58.1%(18/31),明显低于瑞芬太尼组的87.1%(27/31),两组之间相比较差异有显著性(P<0.05).右美托咪定组呼吸抑制、恶心、呕吐发生率均显著低于瑞芬太尼组,且两组之间相比较差异均有显著性(P<0.05).[结论]在RFA术中应用瑞芬太尼麻醉效果优于右美托咪定,但瑞芬太尼术中、术后不良反应发生率较高,二者各有优缺点.     

右美托咪定用于老年患者全身麻醉的临床应用效果探讨

目的研究右美托咪定在老年患者全身麻醉中的应用效果。方法选取2016年9月~2017年3月我院行择期手术的老年患者86例。随机分为对照组和观察组各43例。对照组采取常规全麻用药方案,观察组在对照组基础上应用右美托咪定。对比两组患者麻醉期间丙泊酚、瑞芬太尼用药量、术后复苏情况及MAP、HR、SPO2等变化情况。结果观察组术中丙泊酚、瑞芬太尼用量显著低于对照组,自主呼吸恢复时间、拔管时间均明显短于对照组,差异有统计学意义(P0.05);麻醉前,两组患者MAP、HR、及SPO2对比无显著差异(P0.05);拔管前10min、拔管后观察组MAP、HR及SPO2与对照组比较,差异有统计学意义(P0.05)。结论右美托咪定在老年患者全身麻醉中的效果确切,可降低丙泊酚、瑞芬太尼用药量,促进患者术后早期复苏,围术期生命体征波动小,值得临床推广应用。     

两种麻醉方法在小儿支气管异物取出术中的效果对比分析

目的研究右美托咪定联合表面麻醉与瑞芬太尼联合表面麻醉在小儿支气管异物取出术中的效果对比分析。方法选择2015年2月至2016年12月在该院进行支气管异物取出的患儿84例,按照麻醉方法不同分为观察组和对照组。对照组使用瑞芬太尼联合表面麻醉,观察组使用右美托咪定联合表面麻醉,观察两组患儿不同时间点平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO2)变化及术中不良反应发生情况。结果术中,观察组出现低氧血症、呼吸抑制等不良反应的患儿明显低于对照组,两组差异有统计学意义(P0.05);拔管后20min,观察组MAP、HR值明显低于对照组,差异有统计学意义(P0.05);在支气管镜置入后5min,观察组患儿SPO2较对照组明显升高,两组差异有统计学意义(P0.05);术后,观察组患儿苏醒时间明显短于对照组,两组差异有统计学意义(P0.05)。结论右美托咪定联合表面麻醉较瑞芬太尼联合表面麻醉更适合用于临床小儿支气管异物取出术,为临床小儿支气管异物取出术提供了更多的麻醉方法。     

靶控输注瑞芬太尼与恒速输注右美托咪定用于小儿全凭静脉麻醉苏醒期的临床研究

目的观察靶控输注瑞芬太尼与恒速输注右美托咪定对小儿全凭静脉麻醉苏醒期拔管反应及躁动的影响。方法将90例择期全凭静脉麻醉下行扁桃体腺样体切除术患儿,随机分为对照组(C组)、瑞芬太尼组(R组)和右美托咪定(D组)。麻醉诱导后D组静脉持续输注右美托咪定0.3μg·kg-1·h-1直至气管导管拔出。手术结束前2 min,C组和D组停用异丙酚和瑞芬太尼;R组停用异丙酚,将瑞芬太尼的TCI浓度调整为1.5 ng/ml直至气管导管拔出。记录泵注右美托咪定前(T0)、手术结束时(T1)、拔管前1 min(T2)、拔管时(T3)和拔管后1 min(T4)、5 min(T5)、10 min(T6)的平均动脉压(MAP)、心率(HR);记录停用异丙酚至拔管时间、睁眼时间、拔管时呛咳反应评分;根据儿童麻醉后躁动评分(PAED)和改良加拿大东安大略儿童医院疼痛评分量表(m-CHEOPS),拔管后每5 min对患儿进行躁动和疼痛评分,记录所得最高值作为监测有效值。结果与T0时比较,C组T2~T6时、R组T5~T6时MAP和HR均显著升高(P<0.05),D组各时点MAP与HR差异无统计学意义;与C组比较,R组T2~T4时、D组T2~T6时MAP与HR均较低(P<0.05);与R组比较,D组T5~T6时MAP与HR较低(P<0.05)。三组患儿拔管时间、睁眼时间比较差异无统计学意义(P>0.05);拔管时呛咳反应评分R组与D组显著低于C组(P<0.05),PAED评分和疼痛评分D组显著低于C组(P<0.05)与R组(P<0.05)。结论靶控输注瑞芬太尼(1.5 ng/ml)与恒速输注右美托咪定(0.3μg·kg-1·h-1),均能有效抑制小儿扁桃体腺样体切除术全凭静脉麻醉苏醒期的拔管反应,且不延长麻醉苏醒时间。恒速输注右美托咪定还能减少患儿术后躁动的发生,更适用于小儿全麻苏醒期。     

右美托咪定联合舒芬太尼对心脏手术患者麻醉苏醒期心血管应激及躁动的影响

目的观察右美托咪定联合舒芬太尼对心脏手术患者麻醉苏醒期心血管应激及躁动的影响。方法选择2014年1月至2015年1月该院收治的40例心脏手术患者为研究对象,分为对照组和试验组。对照组患者接受舒芬太尼进行麻醉,试验组患者接受舒芬太尼联合右美托咪定进行麻醉。观察与评估两组患者麻醉苏醒期4个时间点[手术结束前10min(T0)、气管拔管前(T1)、气管拔管后即刻(T2)、拔管后5min(T3)]的血流动力学指标变化与躁动情况,其中血流动力学指标有收缩压、心率与脉搏血氧饱和度。结果 T0时两组患者的心率和收缩压差异均无统计学意义(P0.05),但T1、T2、T3时对照组患者的心率和收缩压都较T0时显著升高,且均明显高于同时间点试验组患者(P0.05)。两组患者在T0、T1、T2、T3时间点的脉搏血氧饱和度差异无统计学意义(P0.05)。试验组患者躁动分级显著低于对照组患者(P0.05)。结论对心脏手术患者麻醉,采用右美托咪定联合舒芬太尼药物,可很好控制全身麻醉苏醒期的心血管反应,使拔管过程更加平稳,且有效避免了患者苏醒期躁动,值得进行临床推广。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.