超声背向散射积分对左心室超声自发性显影与血栓形成的研究

Integrated backscatter quantitative analysis for left ventricular spontaneous echocontrast blood state and thrombus formation of relationship

目的 应用超声背向散射积分 (IBS)定量分析心肌梗死患者的左心室超声自发性显影 (SEC)与血栓形成状态。方法 对 76例心肌梗死患者左心室血液进行IBS检测。受检者分为 3组 :Ⅰ组 ,无SEC ,2 2例 ;Ⅱ组 ,轻度SEC ,3 3例 ;Ⅲ组 ,重度SEC ,2 1例。结果 左心室重度SEC组左心室血栓发生率明显高于轻度SEC组。Ⅰ组未发现有血栓者 ,Ⅱ组发现有血栓 5例 ,Ⅲ组发生血栓 16例。左心室IBS %值越高越易形成左心室血栓及SEC。左心室IBS %值为 2 2 %时 ,区分重度SEC与轻度SEC的敏感性为 66.7%( 14 /2 1) ,特异性为 80 .0 % ( 4 4/5 5 ) ,准确性为 76.3 % ( 5 8/76)。当左心室IBS %值为 12 %时 ,区分有无SEC的敏感性为 66.7% ( 3 6/5 4) ,特异性为 72 .7% ( 16/2 2 ) ,准确性为 68.4% ( 5 2 /76)。结论 IBS技术为检测SEC提供了一种客观、迅速、可靠的方法。

Objective Integrated backscatter (IBS) has been used to quantitating blood state of left ventricular spontaneous and detecting thrombus formation in the patients with myocardial infarction. Methods Quantitative analysis was conducted on blood state of left ventricular in 76 patients with myocardial infarction by integrated backscatter. There was no ventricular smoke-like echoes(SEC) in groupⅠ,mild SEC in groupⅡ,severe SEC in group Ⅲ. Results There were no thrombus in groupⅠ,5 thrombus formation in group Ⅱ,16 thrombus formation in group Ⅲ. IBS% in group Ⅲ was the highest. IBS% in severe SEC group was higher than mild SEC and no SEC group. Patients with higher IBS% tended to form ventricular thrombus and SEC. Moreover,IBS% was also shown an apparent sign of ventricular thrombus formation. The value for determining IBS% was 22% regardless whether mild SEC or severe SEC,and the sensitivity,specificity and accuracy were respectively 66.7 %, 80.0 % and 76.3 %. The value for determining IBS% was 12% regardless whether SEC or no SEC,the sensitivity,specificity and accuracy were respectively 66.7 %, 72.7 % and 68.4 %. Conclusions IBS can provide with objective index of different blood state because it reflects left ventricular spontaneous in patients with myocardial infarction precisely on real time. IBS has an important clinical value as a new method to evaluate left ventricular spontaneous.