心肌背向散射积分参数评价存活心肌的临床研究

目的探讨心肌背向散射积分参数评估缺血后存活心肌的临床价值.方法应用二维超声心动图(2-DE)及背向散射联机分析技术,观测31例陈旧性前间壁心肌梗死患者血管重建术前后前间隔心肌节段运动状态、标化背向散射积分(%AII)、背向散射周期变异幅度(CVIB).结果血管重建术后,62个心肌节段中,45个节段有存活心肌,17个节段无存活心肌.与术前比较,术后45个有存活心肌节段的%AII明显降低(1.6±0.3vs2.3±0.5,P＜0.01),CVIB明显增高(7.2±1.1vs3.4±1.2,P＜0.01).术后有存活心肌节段的%AII及CVIB与无存活心肌节段差异存在显著性意义(均P＜0.05).结论IBS两个参数,即%AII和CVIB,可以区分存活心肌和非存活心肌,能检测梗死区存活心肌.

Clinical study of myocardial integrated backscatter parameters in assessment of viable myocardium

Objective To evaluate the clinical value of integrated backscatter (IBS) tissue characterization in assessing myocardial viability.Methods The two-dimensional echocardiography (2-DE) images of 31 patients with old anterior myocardial infarction were recorded before and about 3 months after revascularization respectively and viable myocardium was identified by comparing with the actual post-revascularization motion improvement of corresponding segments.Two myocardial integrated backscatter parameters,the magnitude of cyclic variation in integrated backscatter (CVIB) and the calibrated average image intensity (%AII),were measured in those patients.Results There existed viable myocardium in 45 of 62 segments and there were no motion improvement in 17 segments after revascularization.%AII was lower and CVIB was higher in the segments with viable myocardium compared with those without viable myocardium.Conclusions Myocardial integrated parameters are considered to be useful to detect viable myocardium.