摘要
目的定量评价急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)术前、术后左心室局部心肌功能和心肌灌注的动态变化。方法选取48例接受PCI手术治疗的1周内AMI患者(治疗组)和30例健康志愿者(对照组),采用斑点追踪成像(STI)及实时心肌超声造影(RT-MCE)技术评价PCI手术前后局部纵向应变及心肌灌注变化特征,并与单光子发射计算机断层扫描术(SPECT)结果进行相关性分析。结果 PCI术前,治疗组各应变和灌注指标均较对照组明显降低。PCI术后1个月,与术前比较,除部分心肌节段心肌造影剂灌注速率无改善外,其他各指标均明显升高,差异有统计学意义(P<0.05);术后1个月,左心室局部纵向峰值应变、心肌灌注达峰强度和局部心肌血流量与单光子发射计算机断层成像术的心肌灌注量呈正相关(r分别为0.75、0.72、0.76,均P<0.05)。结论 STI技术结合RT-MCE技术能够准确评价AMI患者PCI手术前后的左心室局部功能和心肌灌注的变化特征。
Objective To quantitatively evaluate the left ventricular regional myocardial function and myocardial perfusion in patients with acute myocardial infarction （ AMI ） before and after percutaneous coronary intervention （ PCI ） using speckle tracking imaging （ STI ） and real-time myocardial contrast echocardiography （RT-MCE ）. Methods LV length-axis images were acquired in 48 patients with AMI who underwent successful PC I within 1 -month of AMI onset （treatment group）, as well as 30 healthy individuals as control group. Conventional eehocardiography, STI and RT- MCE were done in both 2 groups before and 1 month after PCI. The correlation analysis between the above index and single-photon emission computed tomagraphy （SPECT） after PCI 1 month was also studied. Results Before PCI, a severe reduction in strain and peffusion was observed in treatment group compared to the control group. One month after PCI, there were obvious changes in strain and perfusion index in treatment group, except partial myocardial region in K.Even. Although there were markedly improvement of the most index, significant differences were found between the two groups （P 〈 0.05 ）. One month post operation, local longitudinal peak strain of left ventrieular, myocardial perfusion of peak intensity and regional myocardial blood flow were positively correlated with single photon emission computed tomography amount of＂ myocardial perfusion imaging （SPECT） （r were 0.75,0.72,0.76, P 〈 0.05 ）. Conclusion STI combined with RT-MCE can accurately evaluate the regional myocardial motion and perfusion of AMI patients before and after PCI and can monitor the improvement of myocardial function after revascularization.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2016年第3期264-268,共5页
Journal of China Medical University
关键词
斑点追踪成像
实时心肌超声造影
心肌梗死
speckle tracking imaging
real-time myocardial contrast echocar diography
myocardial infarction
