Assessment of myocardial perfusion by harmonic power Doppler imaging at rest and during adenosine stress: comparison with (99m)Tc-sestamibi SPECT imaging.
Assessment of myocardial perfusion by harmonic power Doppler imaging at rest and during adenosine stress: comparison with (99m)Tc-sestamibi SPECT imaging.
复制标题
通过谐波功率多普勒成像评估静息和腺苷应激期间的心肌灌注：与 (99m)Tc-sestamibi SPECT 成像进行比较。
DOI：
10.1161/01.cir.102.1.55
复制
发表时间：
2000
期刊：
影响因子：
37.8
通讯作者：
Grayburn,PA
中科院分区：
文献类型：
--
作者：
Heinle,SK;Noblin,J;Goree-Best,P;Mello,A;Ravad,G;Mull,S;Mammen,P;Grayburn,PA
背景-谐波能量多普勒成像（HPDI）是一种通过对比超声心动图评估人类心肌灌注的新技术。本研究的目的是比较心肌灌注HPDI与99 mTc-sestamibi单光子发射计算机断层扫描（SPECT）在休息和药理stress.Methods和Results-HPDI进行了123例被称为SPECT成像已知或怀疑冠状动脉疾病。在基线和腺苷输注（0.14 mg · kg−1· min−1×6 min）期间，在3个心尖视图中获得图像。通过HPDI对每个冠状动脉区域的心肌灌注进行分级，分为缺失、斑片状或完全。静息和腺苷之间HPDI显示的持续性心肌灌注缺失或片状心肌灌注被解释为固定缺损，而灌注等级的任何降低被解释为可逆缺损。HPDI和SPECT之间的总体一致性为正常与异常灌注的83/103（81%）。2种方法对3个冠状动脉区域的一致性分别为：左前降支81%（κ=0.57），右冠状动脉76%（κ=0.52），左回旋支72%（κ=0.40）。两种技术之间的差异在回旋区最为显著，HPDI在回旋区观察到33%的固定缺损，而SPECT仅观察到14%的固定缺损（χ2= 15.8，P =0.0001）。
Background—Harmonic power Doppler imaging (HPDI) is a novel technique for assessing myocardial perfusion by contrast echocardiography in humans. The purpose of this study was to compare myocardial perfusion by HPDI with that obtained by99mTc-sestamibi single photon emission computed tomography (SPECT) during rest and pharmacological stress.Methods and Results—HPDI was performed on 123 patients who were referred for SPECT imaging for known or suspected coronary artery disease. Images were obtained at baseline and during adenosine infusion (0.14 mg · kg−1· min−1×6 minutes) in 3 apical views. Myocardial perfusion by HPDI was graded for each coronary territory as absent, patchy, or full. The persistence of absent or patchy myocardial perfusion by HPDI between rest and adenosine was interpreted as a fixed defect, whereas any decrease in perfusion grade was interpreted as a reversible defect. Overall concordance between HPDI and SPECT was 83 (81%) of 103 for normal versus abnormal perfusion. Agreement between the 2 methods for each of the 3 coronary territories was 81% (κ=0.57) for the left anterior descending artery, 76% (κ=0.52) for the right coronary artery, and 72% (κ=0.40) for the left circumflex artery. Discrepancies between the 2 techniques were most notable in the circumflex territory, where fixed defects were observed in 33% by HPDI but in only 14% by SPECT (χ2=15.8,P=0.0001).Conclusions—This study demonstrates that HPDI can reliably detect myocardial perfusion during pharmacological stress, although there was a significantly higher number of falsely abnormal results in the circumflex territory.