利声显经静脉心肌灌注显像的方法学和临床应用研究

摘要

目的 探讨利声显经静脉心肌灌注显像的方法学及临床应用价值.方法 在6例正常人和50例心肌梗死、心绞痛和高血压性心脏病患者专,应用能量多普勒、递增触发和谐波显像的综合显像技术、特殊的仪器设置和利声显静脉输注法,记录心尖四腔观和两腔观,对6个心肌节段的能量多普勒信号进行强度记分分析.结果 在所有患者中获得了满意的心肌显像效果,正常心肌各节段显像的最大记分无显著性差异,但梗死和缺血节段显像的最大记分显著低于正常节段(P<0.05～0.01),室间隔显像的最大记分与左前降支狭窄程度之间呈显著负相关(γ=-0.66,P<0.001).结论 本研究提出的心肌显像方法具有很高的成功率,能够区别正常、狭窄、闭塞和再通的冠状动脉,值得临床推广应用.%Objective To explore the methodology and clinical applications of intravenous myocardial perfusion imaging with Levovist.Methods A set of special instrumental setting and an integrated imaging approach including Power Doppler imaging,incremental triggering imaging and harmonic imaging were utilized to record the apical four-and twochamber views in 6 normals and 50 cases with myocardial infarction, angina pectoris and hypertensive heart disease.The power Doppler signals in 6 myocardial segments were analyzed using a semi-quantitative scoring approach.Results Myocardial perfusion was clearly visualized in all cases.There was no significant difference of nlaxirnal scores among normal myocardial segments while the maximal scores in infarct and ischemic segments were significantlv lower than those in normal segments(P<0.05～0.01).There Was a good eorrelation between the Hlaximal scores in vetoricular septum and theseverity of LAD stenoses(γ=-0.66,P<0.001).Conclusions The imaging approach has a high Success rate with a good capability to differentiate among normal,stenotic,occluded and recanalized coronary arteries and therefore deserves further clinical applications.