超声二次谐波心肌声学造影与冠状动脉造影的对比分析

Comparison Between Myocardial Contrast Echocardiography Using Intermittence Harmonic Ultrasound Imaging and Coronary Angiography

目的 :对比研究超声二次谐波心肌声学造影 (MCE)与冠状动脉造影 (CAG)对冠心病的诊断价值。方法 :静脉注射声学造影剂利声显 (levovist)进行超声二次谐波心肌声学造影 ,按冠脉支配区域将左心室 9段分法进行心肌灌注记分 ,分值与冠脉狭窄程度比较分析。结果 :当心肌灌注MCE分值为 0时 ,相应冠脉狭窄 >85 %的可能性为72 .4 % ,而MCE分值为 1时 ,相应冠脉狭窄 <85 %的可能性为 85 .9% ,冠脉狭窄各组之间MCE分值有显著差异 ,P值均 <0 .0 1～ 0 .0 0 1。结论 :MCE能较准确地反映心肌血流灌注 ,从而判断冠脉病变的程度和部位 ,可作为冠脉造影筛选。

Objective: To compare the value of myocardial contrast echocardiography(MCE) using intermittence harmonic ultrasound imaging and coronary angiography(CAG) for detecting coronary artery heart disease(CHD). Methods: CAG and MCE(using intermittence harmonic ultrasound) were performed in 30 patients. The estimation of MCE score was made by visual analysis from 9 segment model of left ventricular walls according to coronary artery distribution. The severity of coronary stenosis was divided into 4 degrees (Ⅰdegree for stenosis ≤49%,Ⅱ degree for 50%～84%,Ⅲ degree for 85%～99%, Ⅳ degree for 100% stenosis) comparison between MCE score and severity of coronary stenosis was made. Results: When MCE score equals to 0, the possibility of correlated coronary stenosis>85% was 72.4%, when MCE score equals 1,the possibility of correlated coronary stenosis<85% was 85.9%. There was significant difference between scores of different groups divided by severity of coronary stenoses (P<0.01～0.001). Conclusion: MCE exactly reveals the myocardial perfusion, which helps to decide the severity and position of coronary stenosis. It can be an effective method to screen CAG candidates, and evaluate the curative effect after coronary recanalization therapy.