彩色室壁运动显像评价心肌梗塞病人的室壁节段性运动

目的　本研究通过对心肌梗塞病人的室壁运动分析,探索ＣＫ 的临床应用价值。方法　采用惠普５５００超声诊断仪。定量壁运动积分法对比４ 级节段性收缩和舒张期壁运动的ＣＫ 测值。结果　二维长度面积法测ＬＶＥＦ：４７±２％ ,ＡＱ法测ＬＶＥＦ：４３ ±２％ ,二维与ＡＱ 测ＬＶＥＦ 相关（ｒ＝ ０－７２ ,ＳＥＥ＝ ７－８９,Ｐ＜ ０－００１ ,ｎ ＝ ３０） 。正常壁运动７１ 段平均心内膜向内运动１－１５ ±０－１９ｃｍ ,比运动减低７２ 段明显大（ Ｐ＜ ０－０００１）。矛盾运动１３ 段与无运动段有明显差别（Ｐ＜ ０－００１） 。心内膜向外运动的距离在所有壁运动分级也具有明显差别。结论　ＣＫ 显像分析可快速,客观,自动评价节段性壁运动。ＡＱ 是可接受的自动边缘检测方法     

经食管三维彩色室壁动态技术（CK）评价室壁运动准确性的研究

为了检验和评价彩色室壁动态技术跟踪和显示的左室心内膜位移的准确性，我们在２５例患者中同时进行了多平面经食管左室二维超声和ＣＫ技术检查，并利用自制的计算机软件对上述图像进行左室腔体积和ＣＫ色带体积的三维重建，结果显示：左室三维ＣＫ图像不仅可立体显示左室的整体室壁运动状态，而且左室三维重建后的ＣＫ色带体积与三维重建法测量的心搏量高度相关（ｒ＝０．９２，ｐ＜０．００１），从而表明ＣＫ技术是定量分析左室整体室壁运动的可靠方法     

组织谐波成像技术在确定心内膜边界与评价室壁运动中的应用价值

目的：探讨组织谐波成像技术（ＴＨＩ）在显像困难患者的心内膜边界确定和室壁运动评分中的应用价值。方法：６０例因肥胖、肺气过多及高龄原因所致常仙超声显像不满意患者,按标准１６节段进行基波和组织谐波状态下心内膜边界勾画和室壁运动评分分析。结果：谐波状态下心内膜边界评分在全部节段中７１％得到改善,其中包括２９％节段从不能勾画或勾画不良改善为显像较清晰或良好。室壁运动评分在１０８／９６０个节段中更改。结论：     

彩色室壁运动技术评价冠心病节段性室壁运动的临床研究

目的：探讨彩色室壁运动技术（ＣＫ）在定量评价室壁节段性运动异常（ＲＷＭＡ）方面的应用价值。方法：分别以常规二维超声（２ＤＥ）及Ｃ技术对７例冠心病患者及３０例正常人乳头肌水平左室短轴切面室壁节段性运动进行评价。结果：正常组未发现节段性室壁运动异常,收缩期心内膜位移连续均匀,正常节段位移时间范围为２８０～３６０ｍｓ。平均值３２０ｍｓ,位移幅度范围为７～１２ｍｍ,平均值９．５ｍｍ,缺血组织２４例患者出现     

超声心动图检测室壁运动评价冠脉搭桥手术效果及影响因素

目的：应用超声心动图彩色室壁运动技术（ＣＫ）检测室壁运动，以评价冠脉搭桥术效果。方法：对２０例患者（男１８例，女２例，年龄４６￣７３岁）分别于术前、术后测量心内膜位移幅度（ＳＥＭ）及心内膜位移速度（Ｖｓｅｍ）。结果：冠脉拾桥术可使室壁运动功能得到改善，但心肌梗塞的节段室壁运动术后恢复较差，高血压、高指血症及高粘血症对术后室壁运动的早期恢复无影响。结论：ＣＫ技术对评价冠脉搭桥术疗效以及预测再狭窄具有     

彩色室壁动力技术对节段室壁运动的定量研究

目的：应用彩色室壁动力技术（ＣｏｌｏｒＫｉｎｅｓｉｓ,ＣＫ）研究局部心室壁运动。方法：我们以自行研制的计算机软件,通过由乳头肌水平的左室短轴切面和心尖四腔切面ＣＫ图像,获取各节段各时相的区域心内膜位移面积百分比（ＲｅｇｉｏｎａｌＦｒａｃｔｉｏｎＡｒｅａＣｈａｎｇｅ,ＲＦＡＣ）,对４５名正常人和１５名患陈旧性心肌梗死的冠心病患者的ＣＫ图像进行了定量分析研究。结果：正常人相同切面的ＣＫ图像具有比较一致的形态特点,其不同心肌节段在收缩期的ＲＦＡＣ均值有较恒定的范围。心肌梗死患者的ＲＦＡＣ面积堆积图与正常人比较有显著的不同,运动异常的节段其ＲＦＡＣ值明显低于正常人。结论：ＣＫ技术能够实时、客观地展示收缩期各时相心内膜的运动状态,ＲＦＡＣ是ＣＫ技术定量评价室壁运动的较好指标,值得进一步研究并应用于临床。     

超声静脉硝酸甘油及CK技术估测存活心肌的价值

本文采用超声静脉硝酸甘油介入试验（Ｎｉｔｒｏｇｌｙｃｅｒｉｎｅｃｈｏｃａｒｄｉｏｇｒａｐｈｙ，ＮＥ）与彩色室壁运动分析技术（ＣｏｌｏｒＫｉｎｅｓｉｓ）结合（ＮＥ＋ＣＫ）估测存活心肌，并与血运重建术（ＣｏｒｏｎａｒｙＲｅｖａｓｃｕｌａｒｉｚａｔｉｏｎ，ＣＲＶ）后实际改善的心肌节段进行对比研究。结果显示：ＮＥ后室壁运动积分指数（ＷＭＳＩ）明显降低。ＮＥ＋ＣＫ检测冬眠心肌的敏感性为８０．９５％、特异性为７９．３１％、准确性为８０．５３％。ＮＴ时仅有收缩压轻度降低，无一例患者因副作用而终止试验。ＮＥ＋ＣＫ检测冬眠心肌具有较高的诊断价值，特别是硝酸甘油（ＮＴＧ）本身具有抗心肌缺血作用，应用安全、可靠。ＣＫ技术能够实时显示心内膜运动轨迹，提高了识别冬眠心肌的敏感性     

多平面经食管彩色室壁动态技术(CK)评价节段性室壁运动异常准确性的研究

为了评价彩色室壁动态技术（ＣＫ）跟踪显示的室壁运动幅度的准确性，我们在２３例接受多平面经食管超声心动图检查的患者，以多平面经食管二维超声心动图所计算的室壁运动积分值（Ｓｏ）为对比标准，检验了同一切面的经食管ＣＫ技术的积分值（Ｓｃ），结果显示：所有患者均取得了满意的ＣＫ图像，Ｓｏ与Ｓｃ呈高度相关（ｒ＝０．９２，ｐ＜０．００１）。因此，我们认为ＣＫ技术是一种能够客观准确评价局部室壁运动的新技术。     

彩色室壁运动分析技术评价扩张型心肌病左室舒缩运动

目的：评价彩色室壁运动分析（ＣｏｌｏｒｋｉｎｅｓｉｓＣＫ）技术诊断扩张型心肌病（ＤＣＭ）左室舒缩运动的临床价值。材料和方法：应用ＣＫ技术观察２５例ＤＣＭ和３０例正常人的左室壁运动状况，测量左室舒张期和收缩期彩色位移幅度并进行对照分析。结果：ＤＣＭ收缩期和舒张期左室心内膜运动幅度普遍性降低，收缩期彩色位移为０４７±０１６ｃｍ，舒张期彩色位移为０５３±０１７ｃｍ，均明显低于正常人（Ｐ＜０００１）。结论：ＤＣＭ左室舒缩功能均有损害。ＣＫ技术能够简便、准确地评价ＤＣＭ患者的左室舒缩功能。     

门控心肌灌注显像室壁运动及室壁增厚率在鉴别前壁稀疏缺损中的价值

目的 评价门控心肌灌注显像（G-MPI）、室壁运动及室壁增厚率对前壁放射性稀疏缺损鉴别诊断的价值。方法以4种不同的方法来诊断前壁阳性：A心肌血流灌注图像阳性；B心肌血流灌注图像阳性且室壁运动阳性；C心肌血流灌注图像阳性且室壁增厚率阳性；D心肌血流灌注图像、室壁运动及室壁增厚率均阳性。以冠状动脉造影结果为标准，比较4种方法判断前壁稀疏缺损的准确性。结果4种方法判断前壁可逆性稀疏缺损的准确性分别为79．2％、91．7％、95．8％、100％，B、C与A差异无显著性，D与A差异有显著性；4种方法判断前壁固定性稀疏缺损的准确性分别为32．0％、80．0％、88．0％、92．0％，B、C、D与A差异均有显著性。结论G-MPI、室壁运动及室壁增厚率检测可提高前壁稀疏缺损的诊断准确性。     

组织谐波显像诊断胰腺癌的临床应用

目的通过常规基波显像(FI)与组织谐波显像(THI)的对比观察,探讨组织谐波显像诊断胰腺癌的临床应用价值。方法对45例胰腺癌患者(肿块直径小于4cm,无远处转移)进行FI和THI检查,对2种方法所得图像质量进行对比,分析2种检查方法的诊断价值。结果在观察胰腺病灶的大小、边界、内部回声特点、胰管回声及肿块与周围血管的关系等方面,组织谐波显像明显优于基波显像。结论本研究表明,THI可提高胰腺肿块的图像质量,提高病变显示的清晰度及信息量,从而提高诊断准确率。     

Harmonic imaging in fetal echocardiography.

Noncontrast harmonic imaging (HI) has been shown to improve image quality in adults with poor acoustic windows. The utility of fetal echocardiography may be limited by suboptimal acoustic windows, and the use of HI in fetal echocardiography has not previously been defined. The purpose of this study was to compare the quality of fundamental imaging (FI) and HI in fetal echocardiography. Sixty-two fetal echocardiograms, including 44 (71%) with limited acoustic windows, were performed with the use of FI and HI. Image quality and visualization of the ventricles, valves, and the aortic and ductal arches were evaluated and compared between FI and HI. Mean HI scores were higher than mean FI scores for all the structures evaluated. Compared with FI, HI improved the image quality and visualization of cardiac structures in this group of fetuses with predominantly suboptimal acoustic windows. Harmonic imaging is a useful adjunct to FI in echocardiography, and the benefits of HI extend to cardiac imaging in the fetus.     

组织谐频成像与基频成像在心脏声像图中的对比观察

目的:探讨组织谐频成像（THI）与常规基频成像（FI）的对比观察，研究THI改善声像图质量，增强图像的显现力。方法：对150例（标准受检100例、透声差受检50例）心脏（正常或异常）进行观察，分析两种检查的图像质量。结果：FI成像标准受检图像显示优良率81％，透声差受检图像显示优良率64％。THI成像标准受检图像显示优良率91％，透声差受检图像显示优良率88％。结论：无论标准受检或透声差受检THI的图像质量均较FI的图像质量明显改善，可提高诊断的准确性。     

组织谐波显像在胰腺囊性病变诊断中的价值

目的　探讨组织谐波显像在胰腺囊性病变诊断中的临床价值。方法　经手术病理证实的 3 0例胰腺囊性病变患者行二维超声及组织谐波显像检查 ,对组织谐波显像 (THI)与基波显像 (FI)对比分析。结果　组织谐波显像对囊壁边界及内部回声结构的显示均优于基波显像。结论　组织谐波显像能显著提高图像质量 ,提高胰腺疾病的显示率和诊断的准确性。     

谐波成像技术与胃充盈造影在胃癌分期诊断中的应用研究

目的 研究组织谐波成像技术(THI)与胃充盈造影在胃癌显像中对图像质量改善的影响以及在胃癌分期诊断中的临床应用价值.方法 对120例胃癌患者分别采用基波和组织谐波成像,对因各种原因基波成像(FI)不满意患者改用THI技术,观察THI对图像质量的影响,分析THI在肿瘤病灶边界范围确定、病灶浸润深度判定中的准确性,并与手术病理结果对照.结果 24例FI成像质量满意的图像THI与FI显示了良好的一致性(P>0.05),96例FI成像图像质量不满意者在THI状态下69例得到明显改善,平均改善率为 71.9%,二者差异显著(P<0.05).在胃癌分期分析中,对病灶范围小于2和5 cm以下测值的符合率较高,分别为 85.7%和82.5%,误差范围小;>5 cm以上的测值误差范围较大,符合率仅为61.8%;对浸润深度判定与手术病理结果对照,早、中、晚各期符合率分别为 66.7%、75.0%和93.3%.本组资料中超声对肝脏转移的检出率为100%,而对单纯淋巴结转移的检出率仅为60.2%.结论 THI技术能显著改善图像质量;对小病灶范围测值与手术结果有良好的一致性;对胃癌术前分期判断准确性较高;为临床术前预测肿瘤可切除性、选择合理的治疗方案提供较为可靠的量化指标.     

Harmonic imaging with Levovist for transthoracic echocardiographic reconstruction of left ventricle in patients with post-ischemic left ventricular dysfunction and suboptimal acoustic windows.

BACKGROUND: Attempts to perform transthoracic 3-dimensional echocardiography (3DE) are often encumbered by poor definition of chamber borders in adult patients who have technically suboptimal acoustic windows. METHODS: To assess whether harmonic imaging (HI) and contrast agents can facilitate transthoracic 3DE assessment of the left ventricle, we used fundamental imaging (FI), HI alone, and HI coupled with the echo-enhancing contrast agent Levovist in 15 consecutive patients with post-ischemic left ventricular (LV) dysfunction and technically difficult windows. Dynamic 3DE image data sets were obtained at 5-degree angles (36 slices) from a transthoracic apical view. From these data a total of 240 myocardial segments were analyzed with the use of dynamic short-axis paraplane slices at basal, middle, and apical LV levels (standard 16 segment model). For border definition, each segment was scored in random sequence on the following scale by 2 independent investigators: 0 = not seen, 1 = suboptimal visualization, and 2 = well defined. RESULTS: Our results showed a significant increase in the number of well-visualized segments when harmonic mode combined with Levovist injection was compared with FI and HI alone. CONCLUSION: Harmonic imaging alone improves LV assessment by 3DE when compared with FI. Contrast imaging in which Levovist is added to HI further improves the capability of transthoracic tomographic 3DE in the visualization of LV myocardial segments. This could allow 3DE by transthoracic windows to be used more widely in adults for the evaluation of LV volume and function.     

Dobutamine stress echocardiography: improved endocardial border definition and wall motion analysis with tissue harmonic imaging.

BACKGROUND: We performed a study to determine whether tissue harmonic imaging (THI) facilitates wall motion analysis at rest and whether these benefits extend through the stages of a dobutamine stress echocardiography (DSE) study. We also assessed the impact of THI on the feasibility of DSE in technically difficult patients. Finally we tested the hypothesis that THI by improving endocardial border definition (EBD) could enhance the interobserver agreement between trainees and experienced operators for interpreting DSE studies. METHODS: Twenty unselected patients underwent DSE by standard protocol. Parasternal and apical views were obtained with the use of fundamental mode (FND) and THI at baseline, low dose, and peak stress. Segmental EBD was characterized as 1 to 4 (1 = excellent) and segmental wall motion was characterized as 1 to 4/x (1 = normal, x = unable to interpret) by a consensus of 2 experienced observers. A trainee in stress echocardiography independently scored all segments, and these results were compared with the consensus of the experienced readers. RESULTS: EBD improved with THI in 26 +/- 6.7 of 48 segments per patient (54%, 95% confidence interval [CI] 0.40 to 0.68) and deteriorated with THI in only 2 +/- 2.7 (4%, 95% CI 0 to 0.09). Of the total of 48 segments per patient, a mean of 10 +/- 5.7 (21%, 95% CI 0.10 to 0.31) were of inadequate quality to be interpreted for wall motion on FND, and this changed to 4 +/- 3.4 (6%, 95% CI 0.06 to 0.12) on THI (P <.001). EBD improved in a similar degree in all DSE stages 53%, 54%, and 53% for rest, low dose, and peak stress, respectively. Six of the 20 study patients were deemed unsuitable for DSE on FND, and all were changed to suitable subjects on THI. Of the 205 segments deemed unsuitable for interpretation on FND, 140 (68%) were of the anterior and lateral walls of the LV. Improvement with THI was also more prominent on these walls. The mean coefficient of agreement (kappa) for wall motion analysis was 0.82 +/- 0.14 on FND and improved to 0. 92 +/- 0.09 on THI (P <.001). CONCLUSIONS: THI dramatically improves EBD and the ability to confidently score segmental wall motion. Interobserver agreement is also significantly enhanced. These benefits extend to the peak stage of a DSE study. Routine use of THI may enhance the diagnostic accuracy of DSE and extend its application to technically difficult patients previously deemed unsuitable.     

彩色室壁动力分析技术在冠心病中的初步应用

目的：进一步验证彩色室壁动力（ＣＫ）分析技术彩色编码的准确性。方法：对７例冠心病患者,就其彩色编码的方式与核素心肌灌注显像结果进行对比,同时对心内膜移动幅度进行测量分析。结果：两者的显示方式具有高度一致性;冠心病组受累室壁运动幅度明显低于正常对照组。     

High-frame-rate tissue harmonic imaging enhances anatomic M-mode sections of the left ventricle in short-axis view.

BACKGROUND: High-frame-rate echocardiography (HFRE) and tissue harmonic imaging (THI) may improve image quality, thereby enabling anatomic M-mode sections of left ventricular (LV) wall segments to be visualized in various planes in the short-axis view. OBJECTIVES: The goals of this study were to compare image quality between HFRE and conventional-frame-rate echocardiography (CFRE) and between fundamental imaging (FI) and THI, and to obtain anatomic M-mode values of basal short-axis LV segments from healthy subjects for use in the evaluation of abnormal segments in patients with myocardial infarction (MI). METHODS AND RESULTS: The study included 28 healthy subjects and 15 patients with MI who underwent 2-dimensional echocardiography with an ultrasonographic system equipped with THI and anatomic M-mode. Left ventricular image cineloops at the basal short-axis view that were obtained with 3 combinations of imaging techniques (FI + CFRE, FI + HFRE, and THI + HFRE) were digitized and displayed side-by-side in random order for comparison by blinded readers. M-mode sections were done in 3 planes: anteroseptal-posterior, inferoseptal-lateral, and anterior-inferior basal segments. The THI + HFRE combination showed the best image quality with significant reduction in noise artifacts, resulting in a good signal-to-noise ratio and good tractability of all LV segments by anatomic M-mode. In healthy subjects, significant intersegmental differences existed in the diastolic and systolic thicknesses and in the percent systolic thickening of LV segments. In patients with MI, LV systolic thickening was significantly decreased in abnormal segments. No significant differences were noted in ejection fraction and fractional shortening among the 3 anatomic M-mode planes. CONCLUSION: High-frame-rate tissue harmonic imaging improved image quality, thereby allowing reproducible anatomic M-mode measurements in various planes in the short-axis view and providing a convenient objective evaluation of global and regional LV function.     

自然组织谐波成像在儿科中的应用价值

目的　研究自然组织谐波成像 (NTHI)改善二维图像质量在儿科中的应用价值。方法　采用常规超声即基波成像 (FI)和自然组织谐波成像对 46例患儿经胸二维成像。结果　FI成像模糊的 31例患儿共 65 1个节段中有 447个节段左室心内膜显示能力 (EBD)改善 ,总改善率 68.66% ;183个节段EBD加强 ,加强率 2 8%。FI成像清晰的 15例患儿共 315个节段中 ,用NTHI显示效果好于FI的占 12 % ( 38 315 ) ;FI好于NTHI的占 10 % ( 31 315 ) ,NTHI和FI相比无显著性差异 (P >0 .0 5 )。结论　NTHI可提高患儿二维图像的分辨力和对比度 ,明显增强心内膜边界识别能力 ,改善图像质量 ,提高诊断准确率