经静脉心肌声学造影评价心肌梗死后存活心肌的价值

目的　探讨经静脉心肌声学造影 (MCE)对心肌梗死后存活心肌的诊断价值。方法　 2 4例心肌梗死患者用二维超声评价室壁运动情况 ,同时经静脉进行MCE ,以 3个月后静态超声心动图左室心肌节段性运动改善为依据评价MCE对心肌梗死后存活心肌的诊断价值。结果　在 2 4例病人的 384个心肌节段中 ,运动异常节段 184个。在运动异常的 184个节段中 ,MCE1分 39段 ,0 5分 5 0段 ,0分 95段。 3个月复查 79个节段有运动改善 ,其中 39段来自MCE1分的心肌 ,4 0段来自MCE0 5分的心肌。MCE对预测心肌梗死后室壁运动改善的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为 :10 0 %、89 7%、84 8%、10 0 %和 94 6 %。结论　MCE能比较准确地预测心肌梗死后心肌的存活性

Assessment of myocardial viability in patients with myocardial infarction by intravenous myocardial contrast echocardiography

Objective\ The aim of this study is to investigate viable myocardium in patients with myocardial infarction(MI) by intravenous myocardial contrast echocardiography(MCE).Methods\ 24 patients with MI underwent two-dimensional echocardiography,intravenous MCE with intermittent harmonic,pulsed inversion imaging and repeated resting two-dimensional echocardiography at 3-month follow-up and regional function was analyzed.Results\ Of 384 segments in 24 patients,184 segments showed wall motion abnormalities.In these abnormal segments,myocardial contrast score (MCS) was graded as 1 (39 segments),0 5(50 segments) and 0 (95 segments).79 regional wall were improved at 3-month follow-up.These 79 segments included 39 from MCS graded 1 and 40 from 0 5 The sensitivity,specificity,positive predictive value,negative predictive value and accuracy in predicting viable myocardium were 100%,89 7%,84 8%,100% and 94 6% by intravenous MCE.Conclusions\ MCE can accurately detect viable myocardium in patients with MI.