声学密度定量技术与SPECT评价冠心病的对比研究

目的:应用声学密度定量技术(AD)定量分析冠心病患者缺血、梗死心肌,比较AD与SPECT所测相应心肌节段灌注缺损值的关系,探讨AD评价冠心病的价值。方法:入选住院患者77例,根据病史、心电图、心肌酶、SPECT及冠脉造影分为4组:对照组20例;SPECT阳性缺血组16例;SPECT阴性缺血组20例;急性心肌梗死组21例。比较4组患者AD参数及SPECT灌注缺损值。结果:与对照组比较,心肌缺血组及梗死组心肌标化背向散射积分值(IBS%)增高,背向散射积分周期变化幅度(CVIB)减低,周期变化延迟时间校正值(N-Delay)延长(P<0.05);SPECT阳性缺血组与SPECT阴性缺血组比较,CVIB、IBS%及N-Delay均无差异(P>0.05);梗死区心肌CVIB与相应节段心肌SPECT灌注缺损值呈负相关。结论:AD可敏感评价缺血、梗死心肌;与静息SPECT在梗死心肌评价中具有良好相关性;是一种无创评价心肌缺血及心肌存活的新方法。

Value of acoustic densitometry in coronary heart disease: comparison with single photon emission computed tomography

Objective:To observe the change of ischemic and infarct myocardium in patients with coronary heart disease by acoustic densitometry(AD),and clarify whether the abnormalities in AD correlated with myocardial perfusion defects(MPD)of the relative myocardial segments by single photon emission computed tomography(SPECT),and discuss the application worth of AD in coronary heart disease.Methods:The myocardium of 77 inpatient were included.According to history,Electrocardiograph,myocardial enzyme,SPECT and CAG,these patients were divided into four groups:control group(20 cases),ischemic with SPECT positive group(16 cases),ischemic with SPECT negative group(20 cases),AMI group(21 cases).To compare AD parameter and myocardial perfusion defects in these groups.Results:Compared with the control group,calibrated myocardial integrated backscatter(IBS%)was higher,the magnitude of cyclic variation in integrated backscatter(CVIB)was lower and the delayed time of cyclic variation of integrated backscatter(N-Delay)was longer in the ischemia and infarct groups(P<0.05).CVIB,IBS% and N-Delay were no difference in the ischemic with SPECT positive group and SPECT negative group(P>0.05).Infarct myocardial CVIB has a negative correlation with relative MPD.Conclusion:AD can show ischemic and infarct myocardium sensitively.it has a good relation with SPECT in patients with myocardial infarction.AD may provide a new noninvasive tool for assessment of myocardial ischemia and viability.