摘要
目的评价并比较实时心肌声学造影(RT-MCE)半定量、定量不同图像分析方法检测存活心肌的临床价值。方法对27例经彩色超声检查存在左心室壁节段运动障碍的冠心病患者,进行RT-MCE、冠状动脉造影及介入治疗,所有狭窄病变行完全血运重建。RT-MCE图像按美国超声心动图学会16节段划分法获得各运动异常节段显影。图像分析半定量为目测半定量;定量分析法采用QLab软件得出各节段的β值及A×β值,其中β值反映心肌血流速度,A×β值反应心肌血流量。术后1、3、6个月时复查心脏超声,以冠状动脉血运重建后室壁节段运动功能改善为判断存活心肌的金标准。采用图像分析半定量与定量方法对存活心肌进行对比研究。结果在本研究条件下,目测半定量法检测存活心肌的灵敏度、特异度及准确度分别是70.8%、75.3%、72.5%;定量分析法中各节段A值以3.83、β值以0.39和A×β值以1.41为截断点,诊断存活心肌的灵敏度、特异度及准确度分别是81.3%、76.6%、78.2%和84.8%、78.7%、80.7%及76.6%、86.5%、80.3%,RT-MCEA值定量法检测存活心肌的灵敏度、β值定量法检测存活心肌的灵敏度和A×β值定量法检测存活心肌的特异度比目测半定量法均有明显提高(81.3%和70.8%;84.8%和70.8%;86.5%和75.3%,P均<0.05)。结论实时心肌声学造影半定量分析法及定量分析法检测存活心肌有较高的临床价值,定量分析法价值更大。
Objective To compare the value of semi-quantitative real-time myocardial contrast echocardiography to quantitative RT-MCE in detecting viable myocardium. Methods Twenty-seven hospitalized patients with regional wall motion abnormalities （RWMA） according to routine echocardiography underwent RT-MCE,coronary angiography and percutaneous coronary intervention. Every segment image were acquired and evaluated according 16-segment models of American Society of Eehocardiography. Observe the motion of every segment by echocardiography after 1,3,6 months. The images of RT-MCE were analyzed semi-quanti- tatively and quantitatively from microbubble replenishment curves for myocardial perfusion by using the QLab software. The gold standard is that the motion of ventricular segment get better after PCI. Results The sensitivity, specificity and accuracy of semi-quantitive RT-MCE in detecting viable myocardium were 70.8%, 75.3% ,72.5%. The sensitivity,specificity and accuracy of quantitive RT-MCE in detecting viable myocardium were 81.3% ,76.6% ,78.2% and 84.8% ,78.7% ,80.7% and 76.6% ,86.5% ,80.3% respectively when A was 3.83 and 13 was 0.39 and A×β was 1.41 as a cut off point. Compared with semi-quantitive RT-MCE the sensitivity of A,β and the specificity of A×β quantitative RT-MCE raised（81.3% vs 70.8% ; 84.8% vs 70.8% ;86.5% vs 75.3% ,all P 〈0.05） in detecting viable myocardium. Conclusion Semiquantitative and quantitative RT-MCE can be used as valuable measures to detect viable myocardium, quantitative RT-MCE have more value in detecting viable myocardium than semi-quantitative RT-MCE.
出处
《中华医学超声杂志（电子版）》
2011年第6期80-83,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
