瞬间反应式二次谐波显像评价正常犬肝脏超声学造影的实验研究

目的：评价瞬间反应二次谐波显像（Ｔｒａｎｓｉｅｎｔ ｒｅｓｐｏｎｓｅ ｓｅｃｏｎｄ ｈａｒｍｏｎｅｃ ｉｍａｇｉｎｇ,ＴＲＳＨＩ）对正常肝脏声学造影的增强效果及动态变化规律,并与常规连续二次谐波显像进行对比分析。方法：６只健康杂种犬 经外周静脉注射氟碳声学造影剂,分别用常规二次谐波显像和瞬间反应式二次谐波显像扫描肝脏。造影效果评价使用视觉评分和视频密度分析。结果：常规二次谐波显像有４次Ｉ级增强、４     

经静脉心肌造影二次谐波成像对犬心肌灌注的实验研究

目的：初步探讨经周围静脉心肌造影二次谐波成像对心肌灌注的应用效果及意义。方法：对１０只正常开胸犬经周围静脉注入ＳＨＵ－５０８Ａ在二次谐波功能支持下行左室乳头肌短轴切面超声心动图检查,用视频密度仪对造影的前后心肌视频密度进行定量分析。结果：造影剂主心肌的峰值强度,曲线下面积,时间密度改变及曲线升支斜率均较造影前差异显著。     

超声静脉声学造影评价肾外伤血肿的实验研究

目的评价声学造影后使用二次谐波技术在肾外伤时的价值。方法选12只健康新西兰大白兔，应用外力造成左肾钝性损伤的动物模型。经耳缘静脉注入脂质体声学造影剂，分别观察造影前、后血肿显示情况；观察造影后血肿周围肾实质的灰阶显影，用视频灰阶分析技术评价造影效果。结果①造影前后血肿显示情况：造影前，12例中发现9例血肿，病变区轮廓模糊，余3例血肿未确切显示。造影后应用二次谐波显像，12例血肿均完整显示，血肿边界清晰；②视频分析结果：血肿区造影前、后灰阶值无显著性差异（P〉0．05）；周围正常肾实质造影后明显增强，造影前、后灰阶值差异有显著性（P〈0．01）；造影前、后血肿与周围肾实质灰阶差值差异有显著性（P〈0．01），更能衬托出血肿影像。结论声学造影剂可明显增强肾实质显影，有助于区别血肿与周围肾实质，提高肾外伤后血肿检出率，为肾外伤血肿的诊断提供了新的手段。     

组织谐波显像诊断门静脉癌栓的临床应用

目的　评价组织谐波显像 (THI)对诊断门静脉癌栓的应用价值。方法　对 12 8例原发性肝癌患者的 1- 3级门静脉分支分别进行基波显像和THI检查 ,以期发现癌栓存在 ;对照两者在癌栓检出率、边界显示能力和测值等指标的差异。结果　THI在 6 6例中发现门静脉癌栓 ,基波显像检出 4 5例 ,检出率分别是 5 1.5 6 %和 35 .16 % ,两者有显著差异 (P <0 .0 1) ;癌栓边界显示能力THI明显优于基波显像 (P <0 .0 0 5 ) ;两者的测值也有一定差异。结论　THI对门静脉癌栓的较高检出率说明此技术对拓宽超声诊断领域是有价值的 ,可做为基波显像的一个重要补充手段。     

自然组织二次谐波成像在心脏疾病检查中的应用

我院2002年3月～2006年3月对810例不同的患者经胸二维基波成像与二次谐波成像对比，观察显像效果，现报告如下。     

氟碳微泡经静脉声学造影无创评价缺血和梗死心肌的实验研究

目的 :采用氟碳微泡声学造影剂及间歇二次谐波技术 ,评价心肌声学造影 (MCE)在缺血、梗死心肌诊断中的价值。方法 :建立开胸犬急性心肌梗塞动物模型 ,左前降支 (LAD)结扎 3h后 ,经静脉注射全氟显进行 MCE。于左室短轴乳头肌水平测定正常灌注区与缺血低灌注区心肌视频密度时间 -强度曲线参数及灌注缺损心肌范围。实验结束后心脏行组织学染色 ,比较两种方法所测的左室梗死心肌占左室心肌总面积百分比。结果 :心肌造影时间 -强度曲线中 ,正常灌注区与低灌注区的峰值强度 (PI)、强度减半时间 (T1/ 2 )、曲线下面积 (AUC)参数差异有显著性(13.5± 1.9vs2 2 .5± 2 .4 ;16 .6± 0 .9vs9.7± 0 .5 ;2 31.6± 14.9vs4 0 5 .6± 12 .3,P≤ 0 .0 1)。MCE所测定的左室梗死心肌占左室心肌总面积百分比与组织学染色所测定的实际百分比呈正相关 (r=0 .89,P=0 .0 1)。结论 :经静脉注射氟碳微泡声学造影剂 ,运用间歇二次谐波 MCE可定量心肌血流灌注 ,诊断心肌缺血 ,准确测定心肌梗死范围。     

两种自制超声造影剂对正常兔肾脏灰阶造影的对比研究

目的　对比研究两种自制氟碳超声造影剂 (白蛋白类和脂质体类 )在正常兔肾脏灰阶造影中的增强效果。方法　 10只健康家兔均分别经耳缘静脉团注 0 .0 1ml/kg的两种造影剂 ,采用视觉评分 ,动态观察肾皮质、髓质的二维灰阶增强效果。结果　两种造影剂都能明显增强肾皮质和髓质的二维灰阶显像 ,脂质体造影剂对肾皮质、髓质的增强时间明显长于白蛋白造影剂 ,分别为 >3 60 0s对 ( 12 9.3 3± 2 4.16)s、( 2 42 .3 6± 2 9.5 7)s对 ( 79.5 0± 12 .83 )s。结论　两种自制氟碳超声造影剂均可用于肾脏灰阶造影的评价 ,脂质体造影剂明显优于白蛋白造影剂     

利声显声学造影对犬冠脉阻塞前后心肌回声和灌注显像的影响

目的 :探讨犬左前降支 (L AD)阻塞前后利声显声学造影对心肌回声和血流灌注图像的影响。 方法 :健康杂种犬 11条 ,于 L AD阻塞前后注射利声显 ,用 HP Sonos 5 5 0 0型彩超仪、S4超宽频变频探头观察左室乳头肌水平短轴切面心肌回声和灌注显像。 结果 :L AD结扎前注射利声显 ,心肌灰阶值明显增高 ,由 6 2 .5 9± 10 .16增高到 79.2 8± 18.18(P<0 .0 1) ,灌注显像心肌亮度均值为 178.71± 10 .6 3。 L AD结扎后注射利声显 ,L AD供血段心肌灰阶值略增高 ,由 5 7.94± 9.6 4增至 6 4.2 6±16 .86 (P>0 .0 5 ) ,灌注显像不良 ,且回声不均匀。不同犬显像不良心肌的大小和位置不同。结论 :心肌声学造影可清楚显示犬冠脉阻塞前后心肌回声和血流灌注状态 ,并能间接判断冠脉支的走行和分布 ,在冠心病的研究中具有广阔的发展前景。     

正常人利声显心肌声学造影显像效果观察

目的 静脉注射利声显心肌声学造影,比较不同超声切面心肌造影效果,探讨心肌灌注超声显像的最佳切面。方法 采用谐波一能量多普勒和间歇性显像方法,分别采集１５例正常人心尖四腔心、二腔心和胸骨旁四腔心切面的超声图像,观察心肌显像的效果。结果 在标准的心尖四腔、三腔和二腔心切面上在室后间隔、后壁和下壁显影良好,而侧壁、前间壁、前壁和心尖部出现假性充盈减弱或充盈缺损现象;胸骨旁四腔心切面基本可以弥补心尖四腔心     

经静脉声学造影法与彩色多谱勒法对移植肾急性排异反应诊断的对比研究

目的 比较应用间歇二次谐波成像结合声学定量方法与彩色多谱勒血流显像测量阻力指数方法对移植肾急性排异时血流灌注诊断的价值。方法 建立8例犬异体移植肾急性排异模型，进行经静脉声学造影及声学定量和彩色多谱勒血流显像测定阻力指数，同时进行血清肌酐(Cr)监测。结果 声学定量分析所得时间-强度曲线(TIC)参数的灌注曲线下面积(AUC)、峰值强度(PI)及彩色多谱勒血流显像所得阻力指数(RI)与血清Cr值明显相关，相关系数分别为0．978、0．972和0．708；PI-Cr、AUC-Cr相关程度较RI-Cr相关程度高。结论 间歇二次谐波成像技术是检测异体移植肾血流灌注的有效手段，结合声学定量分析技术所获得的TIC参数较RI与移植肾急性排异反应发生的相关性更为密切。     

组织谐波显像对子宫和卵巢病变的诊断价值

目的探讨组织谐波显像（Tissue Harmonic imaging,THI）在子宫和卵巢病变中的临床应用价值。方法对90例子宫和卵巢病变患者进行传统超声成像即基波成像（Fundamental imaging,FI）与THI检查,采用双幅对比,评价图像质量。结果采用FI图像满意率为42.2%,而THI图像满意率达到81.1%,THI明显优于FI,两者间比较有明显差异。结论组织谐波显像可以提高子宫和卵巢病变的图像质量,提供更多诊断信息,从而提高诊断准确率,有很重要的临床应用价值。     

超声组织谐波成像对浅表脏器疾病的诊断价值

目的探讨组织谐波成像在浅表脏器疾病诊断中的临床应用价值。方法对97例甲状腺、乳腺疾病患者分别进行传统超声成像及组织谐波成像。采用双盲方法对上述影像资料进行评价分析。结果组织谐波成像图片评价明显优于传统超声成像,经统计学处理,P〈0．05,二者比较有差异性。结论组织谐波成像可以提高浅表脏器病变图像的质量,有重要的临床应用价值。     

二次谐波显像技术评价左房增大自发性声学显影的临床应用

目的：应用组织二次谐波显像技术(Tissue harmonic imaging,THI)检查风心病左房增大患者，补充常规超声检查所不能显示的自发性声学显影(SEC)，提高超声对自发性显影的诊断能力，为临床提供风心患者发生血栓的诊断依据。方法：对22例左房扩大风心患者。按左房内径大小分为两组。采用经胸超声心动图常规检测后，使用二次谐波显像功能观测左房、左心耳内自发性显影回声，与常规超声对比。结果：在风心病组左房增大者Ⅰ组常规超声及THI均未检测到自发性显影；Ⅱ组常规超声心动图未能检测自发性显影。而THI全部检测到自发性显影。自发性显影呈星云状回声，逆时针旋转，在有陈旧性血栓患者也可见显影。结论：二次谐波显像技术能够提高心脏血栓的诊断率，是常规超声不可缺少的补充。自发性声学显影预示着左房血栓形成和体循环栓塞的的危险性增加。     

自然组织谐波显像超声心动图在高血压病心肌肥厚诊断中的价值

目的　应用自然组织谐波显像 (Nativetissueharmonicimaging简称NTHI)超声心动图测定高血压病患者的心肌厚度。方法　应用NTHI与基波成像 (Fundamentalimaging简称FI)对心肌厚度进行对比测定。 结果NTHI显示左室壁心内膜边缘清晰、心肌回声增强 ,测量心肌厚度准确减少了误差。结论　NTHI能显著改善常规二维图像质量 ,增加了诊断高血压病肥厚心肌的准确性     

Comparison of transthoracic echocardiography with harmonic imaging with transoesophageal echocardiography for the diagnosis of patent foramen ovale

The optimal diagnostic method for patent foramen ovale is currently unclear. This study compared bubble contrast second harmonic transthoracic (TTE) and transoesophageal echocardiography (TOE) on 87 consecutive patients referred for TOE for all indications. A right left shunt was diagnosed in 34 cases (39%), with TTE positive in 26 cases (sensitivity 76.5%), TOE positive in 27 cases (sensitivity 79.4%). Pitfalls of TTE included quality of echo and left sided valve lesions, and for TOE the ability to perform an adequate Valsalva manoeuvre. In conclusion, both tests have similar sensitivity and should be viewed as complementary modalities.     

Comparison of the veracity of real-time perfusion, harmonic angio, and ultraharmonic mocardial contrast imaging mode sine valuation of acute myocardial infarction area

Background Innovative advancements in ultrasound instrumentation present a number of imaging modalities for myocardial contrast echocardiography (MCE) in ischemic syndromes. How well they compare to each other in diagnostic accuracy in the detection of acute myocardial infarction is unclear. The purpose of this study was to assess the relative accuracy of 3 different imaging modes of MCE, low mechanical index (MI) real-time perfusion imaging (RTPI), triggered harmonic angio mode (HA), and ultraharmonic imaging mode (UH) in the detection of acute experimental myocardial infarction within the time frame suitable for potential reperfusion.
Methods MCE was performed in 10 open-chest dogs using RTPI, triggered HA and triggered UH modes at baseline and one hour after occlusion of left anterior descending coronary artery. Presence or absence of perfusion defects, and the perfusion defect size when present, were analyzed and compared with the infarct size delineated by triphenyltetrazolium chloride (TTC) staining.
Results The infarct area was (15.8±2.4)% by TTC staining; Perfusion defect area by MCE was similar to anatomic infarct area in all the three MCE approaches: (16.1±2.7)% by RTPI mode, (15.5±2.9)% by HA mode, and (15.5±3.0)% by UH mode. The sensitivity, specificity and overall diagnostic accuracy in the detection of myocardial infarction were 100%, 88%, and 94% for RTPI mode, 88%, 100%, and 94 % for HA mode, and 100%, 75%, and 88% for UH mode.
Conclusion All modes of MCE, RTPI, triggered HA mode and triggered UH mode have excellent diagnostic accuracy in the immediate hour of acute coronary occlusion within the optimal time frame suitable for reperfusion therapy.

     

Comparison of the veracity of real-time perfusion, harmonic angio, and ultraharmonic myocardial contrast imaging modes in evaluation of acute myocardial infarction area

Background Innovative advancements in ultrasound instrumentation present a number of imaging modalities for myocardial contrast echocardiography （MCE） in ischemic syndromes. How well they compare to each other in diagnostic accuracy in the detection of acute myocardial infarction is unclear. The purpose of this study was to assess the relative accuracy of 3 different imaging modes of MCE, low mechanical index （MI） real-time perfusion imaging （RTPI）, triggered harmonic angio mode （HA）, and ultraharmonic imaging mode （UH） in the detection of acute experimental myocardial infarction within the time frame suitable for potential reperfusion. Methods MCE was performed in 10 open-chest dogs using RTPI, triggered HA and triggered UH modes at baseline and one hour after occlusion of left anterior descending coronary artery. Presence or absence of peffusion defects, and the perfusion defect size when present, were analyzed and compared with the infarct size delineated by triphenyltetrazolium chloride （TTC） staining. Results The infarct area was （15.8-2.4）% by TTC staining; Peffusion defect area by MCE was similar to anatomic infarct area in all the three MCE approaches： （16.1-2.7）% by RTPI mode, （15.5-2.9）% by HA mode, and （15.5-3.0）% by UH mode. The sensitivity, specificity and overall diagnostic accuracy in the detection of myocardial infarction were 100%, 88%, and 94% for RTPI mode, 88%, 100%, and 94 % for HA mode, and 100%, 75%, and 88% for UH mode. Conclusion All modes of MCE, RTPI, triggered HA mode and triggered UH mode have excellent diagnostic accuracy in the immediate hour of acute coronary occlusion within the optimal time frame suitable for reperfusion therapy.