超声造影对节段增厚心肌微循环的评估

目的 采用心肌声学造影定量分析方法评估节段增厚心肌及相邻心肌微循环灌注功能。方法 心肌声学造影的患者32例,其中16例仅有室间隔基底段增厚为A1组,室间隔中段为A2组；对照组16例室间隔相应节段为B1组及B2组。比较四组心肌灌注的峰值强度值(A)、上升斜率值(k)、达峰时间(T) 、A*K值及时间-强度曲线特点。分析A1/A2及B1/B2的A、K 、T及A*K比值。结果 A1组灌注达峰时间T延迟,A值、K值及A*K值均低于其他三组(p<0.05)；A2组的T、A*K值与B2组具有统计学意义 (p<0.05)；A1/A2的A、K及A*K比值低于B1/B2(p<0.05),A1组与A2组的时间-强度曲线较B1与B2组分离更明显。结论 节段增厚心肌及相邻心肌微循环均存在灌注异常,定量心肌声学造影可早期反应局部心肌微循环功能障碍。

Evaluation of microcirculation of segmental hypertrophic myocardium by contrast-enhanced echocardiography

Objective To evaluate the microcirculatory perfusion function of the thickened and adjacent myocardium by quantitative analysis of myocardial contrast echocardiography(MCE). Methods Among 32 patients with MCE, 16 patients had only thickening of basal segment of interventricular septum (group A1) and middle segment of interventricular septum (group A2); 16 patients in control group had corresponding segments of interventricular septum (Group B1 and group B2). The peak intensity (A), ascending slope (k), peak time (T), A * k and time-intensity curve of myocardial perfusion were compared among the four groups. The ratio of A, K, A * k and T of A1 / A2 and B1 / B2 were analyzed. Results In group A1, A-value, k-value and A* k-value were lower than the other three groups (P < 0.05).The T-value, A* k-value of group A2 were statistically significant with that of group B2 (P < 0.05). The A-value, k-value and A* K ratio of group A1 / A2 were lower than that of group B1 / B2 (P < 0.05), and the time-intensity curve separation of group A1 and group A2 was more distinct than that of group B1 and group B2. Conclusion There were perfusion abnormalities in the segment thickened myocardium and adjacent myocardial microcirculation. Quantitative MCE could early reflect the local myocardial microcirculation dysfunction.