冠心病患者心肌声学造影定量分析的初步研究

拟探讨MCE定量分析在缺血性心脏病上的诊断价值。对10例临床诊断冠心病的患者行MCE,从时间-强度曲线中获得造影剂再灌注强度峰值(SIpeak),再灌注时间(Rt),再灌注率(b)和心肌血流量(SI×b)。同一检查对象不同心肌节段的4个参数(SIpeak、Rt、b和SI×b)均有统计学上的差异(P<0.05),对照组和观察组SIpeak具有统计学上的差异,SIpeak预测缺血性心脏病的ROC曲线下面积(AUC)为0.782,最佳临界值为64.4,以SIpeak≤64.4来预测缺血性心脏病,敏感性83.3%,特异性69.0%。利用超声造影匹配成像技术能够较满意地显示心肌灌注状态,初步研究表明通过MCE及Qontrast多参数定量分析软件可以评价心肌梗死区和缺血区的血流灌注缺损。SIpeak是预测缺血性心脏病的敏感指标。

The Value of Quantitative Analysis of Myocardial Contrast Echocardiography in Diagnosing Coronary Atherosclerotic Heart Disease

This study was aimed to evaluate the quantitative analysis of MCE in diagnosing coronary atherosclerotic heart disease. MCE was performed on 10 patients with coronary artery disease. The parameters were extracted from imaging during the refilling period by time-intensity curve. SIpeak represents the peak of the signal intensity at the end of the perfusion process. Rt denotes refilling time, b indicates refilling rate. SI x b represents myocardial blood flow. SIpeak, Rt, b and SI x b showed significant differences in various segment of one patient. SIpeak exhibited significant difference between the control and observation groups (P < 0.05). The area under curve (AUC) of ROC was determined to be 0.782 and the optimum critical point was 64.4. SIpeak < or = 64.4 could predict the risk of coronary atherosclerotic heart disease with a sensitivity of 83.3% and a specificity of 69.0%. With the use of CnTI, myocardial perfusion was satisfactorily shown. The data from this initial study indicate that MCE and Qontrasts quantitative analysis software can evaluate the defect and damage area of myocardial infarction and low blood flow. SIpeak is a valuable predictor of coronary atherosclerotic heart disease.