实时超声造影对心肌梗死后患者心肌微循环灌注的评价

目的:探讨实时心肌造影超声心动图(MCE) 对心肌梗死(MI)后患者心肌微循环灌注的半定量评价.方法:对17例MI后患者进行SonoVue低机械指数实时MCE,左心室壁分为16节段,MCE心肌微循环灌注评价采用3级分法:0分:无造影剂显影,1分:轻度显影或节段内不均匀显影,2分:明显及均匀显影.结果:MCE 0分节段数为82,1分节段数为68,2分节段数为212.其0分节段数明显少于2DE的室壁无动力 反常运动节段数, 1分节段数明显多于运动减低节段数(82 vs 98, P＜0.05;68 vs 51, P＜0.01).结论:实时MCE可清楚地显示MI后心肌微循环灌注情况,并提示2DE室壁无动力节段内可能存在部分存活心肌.

Assessment of Myocardial Micro-circulation Perfusion by Real-time Contrast Echocardiography in Patients with Post-myocardial Infarction

Objective:To study the efficacy of real-time myocardial contrast echocardiography(MCE) in half quantitative assessment of myocardial micro-circulation perfusion in patients with post-myocardial infarction.Methods:17 patients with post-myocardial infarction underwent lower machine index MCE using SonoVue contrast agent.Estimations of left ventricle wall motion were made by visual analysis in 16-segment model.Myocardial micro-circulation perfusion were scored as 0(contrast deficit),1(partial and non-homogenous contrast) and 2(complete and homogenous contrast).Results: The segment numbers of MCE scoring 0,1,and 2 were 82,68 and 212 respectively.Segments scoring 0 were fewer than those with non-dynamict contradictive motion on 2DE,as were segments scoring 1 than those with low-dynamic motion(82 vs 98,P<0.05;68 vs 51,P<0.01).Conclusion:Real-time MCE could clearly show the segments of myocardial micro-circulation perfusion in post-myocardial infarction.In addition,it points to the potential presence of viable myocardium at the 2DE non-dynamical motion segment.