Assessment of resting perfusion with myocardial contrast echocardiography: Theoretical and practical considerations
Assessment of resting perfusion with myocardial contrast echocardiography: Theoretical and practical considerations
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DOI：
10.1016/s0002-8703(00)90231-x
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发表时间：
2000-02-01
影响因子：
4.8
通讯作者：
Kaul, S
中科院分区：
文献类型：
--
作者：
Lindner, JR;Villanueva, FS;Kaul, S
背景本研究的目的是对既往有心肌梗死(MI)患者的心肌声学造影(MCE)和单光子发射计算机断层扫描(SPECT)进行定量比较。我们还希望确定在临床环境下静脉注射超声造影剂的最佳方法。方法和结果17例SPECT上单个血管区域静息灌注缺陷的患者。所有17例患者均在持续输注第二代超声造影剂(Sonovue)的同时和其中8例患者在团注后进行了间歇谐波成像。在连续输注过程中，8个心动周期的搏动间隔(PI)的异常心肌与正常心肌的视频强度(VI)比值与这些节段之间的活动性比值在SPECT上有很好的相关性(r=0.73，P<0.01)。当加入微泡速度(MV)随PI增加而变化的信息时，与SPECT活动性比率的相关性显著改善(P<；0.05)(r=0.87，P<；0.0001)。微泡剂量越高，在连续输注过程中VI越高，心肌显影良好：在达到最大剂量之前，远场衰减不明显。团注时，1个和5个心动周期PI时异常心肌和正常心肌的VI比值与SPECT上这些区域的活动比值呈轻度相关(分别为r=0.46和r=0.48，P<0.05)。当一次微泡注射产生充分的心肌混浊时，必然会导致远场衰减。结论在既往有心肌梗死的患者中，定量评估MCE上的静息灌注缺陷与SPECT上的局部活动有很好的相关性。持续输液比团注更有优势，因为它们可以提供相对VI和MV的评估。微泡灌注率的调整可产生充分的心肌混浊而不衰减。
Background The aim of this study was to perform a quantitative comparison between myocardial contrast echocardiography (MCE) and single-photon emission computed tomography (SPECT) in patients with prior myocardial infarction (MI). We also wanted to determine the optimal method for the intravenous administration of an ultrasound contrast agent in the clinical setting.Methods and Results Seventeen patients with resting perfusion defects in a single vascular territory on SPECT were-studied. MCE was performed with intermittent harmonic imaging during continuous infusions of a second-generation ultrasound contrast agent (Sonovue, Bracco Diagnostics) in all 17 patients and after bolus injection in 8 of them. During continuous infusions, the video intensity (VI) ratio between the abnormal and normal myocardium at a pulsing interval (PI) of 8 cardiac cycles correlated well with the activity ratio between these segments:on SPECT (r = 0.73, P < .01). When information regarding microbubble velocity (MV) denoted as change in VI with increasing PIs was added, the correlation with SPECT activity ratio improved (P < .05) significantly (r = 0.87, P < .0001). Higher microbubble doses resulted in higher VI during Continuous infusions with good myocardial opacification:and no Far-field attenuation until the highest dose was reached. With bolus injections, the VI ratio between the abnormal and normal myocardium at PI of 1 and 5 cardiac cycles showed a modest correlation (r = 0.46 and r = 0.48, respectively,: P < .05) with activity ratios between these regions on SPECT. When a dose of microbubbles administered as a bolus produced adequate myocardial opacification, it invariably resulted in far-field attenuation.Conclusions In patients with prior MI, quantitative assessment of resting perfusion defects on MCE correlates well with regional activity on SPECT. Continuous infusions offer an advantage over:bolus injections because they can provide an assessment of both relative VI and MV. Adjustment of the microbubble infusion rate produces adequate myocardial opacification without attenuation.