实时超声造影对心肌梗死后患者心肌微循环灌注的评价

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

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(82vs98,P<0.05;68vs51,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。

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 microcirculation 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： Realtime 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.