扩张型心肌病心肌组织超声背向散射积分特性的临床研究

Clinical study of the myocardial ultrasonic integrated backscatter in patients with dilated cardiomyopathy

目的 应用心肌组织超声背向散射积分(IBS)技术研究扩张型心肌病患者的声学特性及临床意义。方法 采用HPSONOS 5500彩色多普勒超声诊断仪配备声学密度定量(AD)分析软件,对比检测20例扩张型心肌病患者和20例正常人胸骨旁长轴观室间隔基底段及后壁、乳头肌水平短轴观中段室间隔及后壁的背向散射信号,获得IBS平均值、IB最大值及CVIB(周期变异率)及曲线形态。其中病例组5例进行复检。结果 扩张型心肌病组各节段的IBS校正平均值、IBS校正最大值均显著高于正常组(P<0.05),CVIB值则低于正常组(P<0.05),曲线形态多数呈不规则类型。5例复检患者中2例随临床症状改善而心肌IBS值较前有所降低、CVIB值有所增高。结论 扩张型心肌病患者的心肌IBS值升高、CVIB值减低、曲线形态异常,提示该病患者心肌间质纤维化增多,心肌收缩力呈某种程度丧失。心肌IBS值与心肌收缩力相关联,经治疗心功能改善者心肌IBS值有所降低、CVIB值有所增高。提示此类患者心肌间质纤维化较轻。

Objective The objective of this study was to evaluate the acoustic characteristics and clinical significance of dilated car-diomyopathy with a technique of the myocardial ultrasonic integrated backscatter(IBS). Methods The subjects including 20 dilated cardiomy-opathy and 20 normal controls acquired IBS averages, IB maximum values, cyclic variation of IBS (CVIB) and curve characteric at a color Doppler ultrasound system (HP SONOS 5500) with parasternal long axis view of inter-septum and posterior wall and short axis view of papillary muscle level and posterior wall. Among 20 patients,5 patients were reinvestigated. Results Calibrate average IBS and maximum IBS of various segments in patients with dilated cardiomyopathy were significantly higher than that in the normal controls(P<0.05). The types of curve character were irregular. Following the improved clinical state, IBS was reduced and CVIB was increased as compared with before in 2 patients of 5 reinvestigated dilated cardiomyopathy. Conclusions Increased IBS, reduced CVIB and abnormal curve character are seen in dilated cardiomyopathy, that accounts for significant myocardial fibrosis and damaged function of myocardial contraction. The heart is improved after treatment, IBS is reduced and CVIB is increased, in which there may be the reversible indication.