背向散射积分、组织多普勒与核素扫描对心肌缺血和存活的相关性临床研究

目的:进一步探讨组织多普勒和组织定征技术临床应用的可行性。方法:12例超声发现节段性室壁运动失常患者分别进行多巴酚丁胺负荷超声心动图、超声组织多普勒、背向散射积分及核素扫描检查。结果:有收缩储备节段背向散射积分曲线形态评分较无收缩储备节段明显降低,背向散射积分周期变异幅度(CVIB)、T波顶点时心内膜运动速度(Vendo)、心肌中部心动周期中最大运动速度(TVC)、收缩期心肌运动速度峰值跨壁梯度(MVGm+)及放射性核素摄取率均较无收缩储备节段显著增高,有收缩储备节段背向散射积分平均值(AII)与无收缩储备节段的差别无显著性。心肌收缩期运动指标与CVIB正相关,与AII负相关。放射性核素摄取率与TVC、Vendo、MVGm+正相关,与AII负相关,与CVIB相关呈临界状态。结论:背向散射积分和组织多普勒指标在判断心肌缺血与存活的临床应用方面有很大潜力。

A relative study of integrated backscatter, tissue Doppler imaging and SPECT in myocardial ischemia and viability

Objective: To investigate the clinical feasibility of integrated backscatter(IBS) and tissue Doppler imaging(TDI) in diagnosing myocardial ischemia and viability. Methods: Twelve patients with regional wall motion abnormalities were examined under DSE, IBS, TDI, and TI-SPECT just before coronary revascularization. Results: With the contraction reserve as "gold criterion", IB curve score was lower in viable myocardium than that in non-viable myocardium. Conversely, the magnitude of CVIB, the velocity of endocardium and myocardium, the MVG and the emission count in the viable myocardium were higher than those in the non-viable myocardium. The AII did not show significant difference between the viable myocardium and the non-viable myocardium. CVIB and emission count correlated positively to the indices of myocardial motion. AII correlated negatively to the indices of myocardial motion. The emission count correlated negatively to AII, weakly correlated to CVIB. Conclusion: IBS and TDI have great potentialities in the diagnosis of myocardial ischemia and viability.