心脏血管解剖与心肌灌注:血管造影与心肌造影超声心动图比较研究

Coronary anatomy and myocardial perfusion: Contrast echocardiography during coronary arteriography in humans

目的:探讨正常心脏血管造影与心肌微血管灌注区域之间的关系。方法:24例血管造影正常者,同时行左右冠脉声学造影,取左室短轴切面乳头肌水平观察心肌回声增强的心肌节段数,评价左右冠脉心肌灌注区域的范围。结果:1、2、3、4、8、9节段心肌100%由左冠脉供血,6段100%由右冠脉供血,而5、7、10段心肌的供血血管有变异,下壁91.7%由右冠脉供血,而室间隔中部62.5%的血供源于左冠脉。结论:心脏表面的大血管不能完全真实的反映心肌灌注范围,相同的优势动脉亦可有不同的心肌灌注节段。

In order to determine the relationship between myocardial blood flow and epicardial coronary anatomy in humans, 24 patients With normal coronary arteries in arteriography underwent myocardial contrast echocardiography (MCE) through intracoromary injection of 1.5 to 2.0 ml of sonicated albumin. Twodimensional contrast echocardiography imaging was obtained at mid-papillary, cross-sectional muscle level. The results demonstrated that the left coronary (LC) system always supplied the region 1, 2, 3, 4, 8, 9 of left ventricle and the right coronary artery (RCA) perfused region 6, 10 in all patients; interior region was perfused from RCA in 91.7% and mid-septum from LC in 62.5% of the patients. It was concluded that arteriography can't really reveal the area of perfusion. The different dominant vessels may have same perfusion pattern.