经静脉实时心肌声学造影评价犬急性心肌梗死的实验研究

The experimental study on canine acute myocardial infarction with intravenous real-time myocardial contrast enhancement imaging

目的 研究实时心肌声学造影检出犬急性心肌梗死的效果。方法 8只开胸犬结扎第一对角支起点以下冠脉左前降支主干 ,分别于结扎前、结扎后 1h和 3h静滴全氟显 (5ml/min)进行实时心肌声学造影 ,左室乳头肌水平短轴切面观察造影效果和室壁运动 ,并与病理染色比较。结果 结扎后 1h及 3h ,实时心肌声学造影均能良好显示缺血区的造影剂充盈缺损 ,包括缺损大小、位置与形态 ,同时清楚显示缺血区室壁运动异常。与病理染色比较 ,充盈缺损区大于心梗区。闪烁显像很好反映出充盈缺损区周围心肌血流再灌注减慢。结论 实时心肌声学造影可同时观察心肌灌注和室壁运动 ,闪烁显像具有定量评价心肌血流灌注的潜在价值 ,操作简便 ,具有良好的应用前景。

Objective To assess the value of real time myocardial contrast enhancement imaging (real time MCE) on acute myocardial infarction.Methods Eight open chest canine models of myocardial infarction were established by ligating left anterior descent branch of coronary artery (LAD) on level after first diagonal branch. The real time MCE, using intravenous instillation of a new kind of Perfluorocarbon contrast agent, were performed before the occlusion, 1 hour and 3 hours after the occlusion. The myocardial contrast agents perfusion and wall motion was observed on the middle of papillary muscles scan plane.Results The real time MCE showed not only the black aridity of contrast agents but also the wall motion abnormality 1 hour and 3 hours after the occlusion. In comparison with pathology, the defects of contrast perfusion were larger than the stained infarction zones. In addition, the flash contrast imaging revealed the reperfusion defect of adjacent zones.Conclusions With the ability of showing the myocardial microcirculation and wall motion function simultaneously, the real time MCE makes MCE exam significantly easier to perform. Finally, flash contrast imaging will be the cornerstone upon which perfusion quantification will be built.