经静脉心肌声学造影评价心肌梗死后存活心肌的价值

Assessment of myocardial viability in patients with myocardial infarction by intravenous myocardial contrast echocardiography

目的 探讨经静脉心肌声学造影 (MCE)对心肌梗死后存活心肌的诊断价值。方法 2 4例心肌梗死患者用二维超声评价室壁运动情况 ,同时经静脉进行MCE ,以 3个月后静态超声心动图左室心肌节段性运动改善为依据评价MCE对心肌梗死后存活心肌的诊断价值。结果 在 2 4例病人的 384个心肌节段中 ,运动异常节段 184个。在运动异常的 184个节段中 ,MCE1分 39段 ,0 5分 5 0段 ,0分 95段。 3个月复查 79个节段有运动改善 ,其中 39段来自MCE1分的心肌 ,4 0段来自MCE0 5分的心肌。MCE对预测心肌梗死后室壁运动改善的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为 :10 0 %、89 7%、84 8%、10 0 %和 94 6 %。

Objective\ The aim of this study is to investigate viable myocardium in patients with myocardial infarction(MI) by intravenous myocardial contrast echocardiography(MCE).Methods\ 24 patients with MI underwent two-dimensional echocardiography,intravenous MCE with intermittent harmonic,pulsed inversion imaging and repeated resting two-dimensional echocardiography at 3-month follow-up and regional function was analyzed.Results\ Of 384 segments in 24 patients,184 segments showed wall motion abnormalities.In these abnormal segments,myocardial contrast score (MCS) was graded as 1 (39 segments),0 5(50 segments) and 0 (95 segments).79 regional wall were improved at 3-month follow-up.These 79 segments included 39 from MCS graded 1 and 40 from 0 5 The sensitivity,specificity,positive predictive value,negative predictive value and accuracy in predicting viable myocardium were 100%,89 7%,84 8%,100% and 94 6% by intravenous MCE.Conclusions\ MCE can accurately detect viable myocardium in patients with MI.