彩色多普勒冠脉血流显像对照冠脉造影评价前降支动脉的初步研究

目的 探讨经胸超声的彩色多普勒冠脉血流显像技术评价左前降支动脉(left anterior descending artery，LADA)全程的临床价值。方法 对44例行冠状动脉造影前的患者行经胸超声检查，评价其左前降支动脉全程，并与冠脉造影作对照，然后回顾性分析LADA正常组与狭窄组的血流参数。结果 本组29段LADA狭窄段，超声检出20段，其特异性为100％，敏感性为69％，阳性预测值和阴性预测值分别为100％和91．2％。正常组与狭窄组间舒张期的峰值流速、平均流速、加速度、减速度、速度时间积分、减速时间均有显著差异。正常组LADA的近、中、远三段的各项血流参数无统计学差异。结论 经胸冠脉血流显像技术能反映LADA的血流动力学信息，是全面评价LADA的一种简便、实用的方法。

Preliminary Noninvasive Evaluation on Left Anterior Descending Artery Using Transthoracic Color Doppler Coronary Flow Imaging Compared with Coronary Angiography

Objective To evaluate the feasibility and credibility of clinical implementing of transthoracic color Doppler coronary flow imaging (CDCFI) on assessing left anterior descending coronary artery (LADA).Methods We first prospectively evaluated the entire LADA of 44 patients scheduled for coronary angiography(CA) with CDCFI and measured series flow indices,and then we assessed the specificity,sensitivity of CDCFI for coronary stenosis and compared the flow parameters between normal segments and stenosed segments of LADA.Results Of the 29 stenosed segments,transthoracic CDCFI correctly diagnosed 20 segments.The specificity of CDCFI for coronary stenosis was 100% while the sensitivity of it was 69%.The positive predictive value and negative predictive value was 100% and 91.2% respectively.There were significant differences between several diastolic flow parameters of normal segments and stenosed segments of LADA such as peak velocity,mean velocity,accelerated rate,decelerated rate and so on.Among the proximal,middle,and distal parts of normal LADA,all the corresponding flow parameters had no statistical differences.Conclusions Transthoracic CDCFI can reflect dynamic information of LADA and may be a valuable,simple noninvasive method for evaluating LADA.