超声背向散射技术定量评价冬眠心肌的临床研究

目的　探讨心肌背向散射积分参数定量评价陈旧性心肌梗死后存活心肌。方法　于乳头肌水平左室短轴切面记录 2 5例心肌梗死患者的超声背向散射图像 ,比较经皮冠状动脉球囊成形术 (PTCA)治疗前、后心肌背向散射积分周期变异 (CVIB)和标化CVIB(CVIB % )的变化。结果　按不同节段分组比较 ,经二维超声心动图判断为存活心肌的CVIB及CVIB %术后较术前有显著性的提高。若以CVIB %增加 (△CVIB % ) >10为判断冬眠心肌的标准 ,则敏感性、特异性、准确性分别为 81.3 %、87.5 %、83 .3 %。结论　对于陈旧性心肌梗死患者 ,CVIB和CVIB %可作为评价冬眠心肌的定量、客观的指标运用于临床。

A Clinic Study of Hibernating Myocardium with Ultrasonic Integrated Backscatter Evaluation

Objective To evaluate cyclic variation of integrated backscatter (CVIB) and calibrated CVIB (CVIB%) in diagnosing viable myocardium after old myocardial infarction (OMI). Methods Twenty five patients with OMI were studied by ultrasonic integrated backscatter before and 6 weeks after percutaneous transluminal coronary angioplasty (PTCA). CVIB and CVIB% of 4 segments in parasternal papillary short axis view were analyzed. Results CVIB and CVIB% increased significantly 6 weeks after PTCA. With CVIB% increasing more than 10 as standard for diagnosing hibernating myocardium, the sensitivity, specificity, and accuracy were 81.3%, 87.5% and 83.3% respectively. Conclusion CVIB and CVIB% were valuable for diagnosing hibernating myocardium quantitatively and objectively.