实时心肌声学造影对扩张型心肌病心肌灌注的评价

Assessment of Myocardial Perfusion with Real-Time Myocardial Contrast Echocardiography in Patients with Dilated Cardiomyopathy

目的采用实时心肌声学造影(RT-MCE)定量评价扩张型心肌病(DCM)患者心肌微循环灌注的状况。方法使用Philips EPIQ 7C及X5-1探头,对23例DCM患者和18例健康志愿者进行常规心脏超声参数测量后,经静脉给予声诺维(SonoVue)进行RT-MCE。采用Q-Lab10.8软件进行左心室各节段心肌灌注的定量分析。结果扩张型心肌病(DCM)组的常规心脏超声参数左室舒张末期内径(LVDd)、左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)较正常对照组明显升高(P<0.01),左室短轴缩短率(LVFS)和左室射血分数(LVEF)较正常对照组明显降低(P<0.01)。DCM组左心室各节段的RT-MCE参数峰值强度(A)、曲线平均斜率(β)、心肌血流量(MBF)较正常对照组明显降低(P<0.01)。结论 RT-MCE可用于定量评价DCM患者的心肌微循环灌注状况,为临床评价心肌血流量提供参考。

Objective To quantitatively evaluate the status of myocardial microcirculation perfusion in patients with dilated cardiomyopathy（DCM）using real-time myocardial contrast echocardiography（RT-MCE）.Methods Twenty-three DCM patients and 18 healthy controls were given conventional echocardiographic measurements using the Philips EPIQ 7 Cwith X5-1 probe,followed by intravenous administration of SonoVue for RT-MCE.Myocardial perfusion of different segments of left ventricle was quantitatively analyzed using Q-lab10.8 software.Results Compared with control group,the left ventricular end-diastolic diameter,end-diastolic volume and end-systolic volume increased,but the left ventricular fractional shortening ratio,ejection fraction,RT-MCE parameter peak intensity,average curve slope and myocardial blood flow decreased in DCM group（P〈0.01）.Conclusion RT-MCE can be used as a new method for clinical assessment of myocardial blood flow to quantitatively evaluate the perfusion of myocardial microcirculation in patients with DCM.