Potential pitfalls of visualization of myocardial perfusion by myocardial contrast echocardiography with harmonic gray scale B-mode and power Doppler imaging
Potential pitfalls of visualization of myocardial perfusion by myocardial contrast echocardiography with harmonic gray scale B-mode and power Doppler imaging
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DOI：
10.1023/b:caim.0000014100.36283.fe
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发表时间：
2004-04
期刊：
影响因子：
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通讯作者：
H. Masugata;K. Yukiiri;Y. Takagi;K. Ohmori;K. Mizushige;M. Kohno
中科院分区：
文献类型：
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作者：
H. Masugata;K. Yukiiri;Y. Takagi;K. Ohmori;K. Mizushige;M. Kohno
目的：方法：对12例患者采用心电门控间歇触发心肌声学造影（MCE），缓慢静脉注射0.5ml声学造影剂（Optison®），采用谐波灰阶和能量多普勒成像技术，对MCE显示心肌灌注时心肌信号强度的区域变化进行比较。ECG触发之间的间隔（脉冲间隔）从每次心跳（1：1）增加到每2（1：2）、4（1：4）和8（1：8）个心动周期，以允许微泡（造影剂）补充。当左心室腔产生的衰减最小时记录MCE图像。在心尖四腔心切面上测量7个节段的背景信号强度：3个（心尖、中间和基底）间隔节段，3个（心尖、中间和基底）侧节段，1个心尖节段（心尖帽）。在灰阶成像中，基底隔段的背景信号强度在所有脉冲间隔均为负值，在1：8脉冲间隔时，基底隔段的背景信号强度（-9 ± 13）明显低于顶外侧段的背景信号强度（22 ± 20）（p< 0.01）。能量多普勒超声在室间隔基底段的减背景信号强度也很高（112 ± 33），各节段间无显著性差异。结论：在谐波灰阶超声远场，尽管图像分析的衰减不明显，但基于减背景信号强度的心肌灌注定量评价可能是困难的。与谐波灰阶成像相比，谐波能量多普勒在检测基底动脉灌注方面更敏感。
Objective: The present study compared the regional variation of myocardial signal intensity in visualizing myocardial perfusion by myocardial contrast echocardiography (MCE) between harmonic gray scale and power Doppler imaging.Methods: MCE was performed in 12 patients by electrocardiographic (ECG)-gated intermittent triggered MCE with harmonic gray scale and power Doppler imaging following slow intravenous injection of 0.5 ml contrast agent (Optison®). The interval between the ECG triggers (pulsing interval) was increased from every heart beat (1:1) to every 2 (1:2), 4 (1:4), and 8 (1:8) cardiac cycles to allow incremental microbubble (contrast agent) replenishment. The MCE images were recorded when attenuation produced by the left ventricular cavity was minimal. The background-subtracted videointensity was measured in 7 segments in an apical 4-chamber view: 3 (apical, mid, and basal) septal segments, 3 (apical, mid, and basal) lateral segments, and 1 apex segment (apical cap).Results: The background-subtracted videointensity for each segment was greater with the power Doppler than the gray scale imaging (p< 0.01). With the gray scale imaging, the background-subtracted videointensity in the basal septal segment demonstrated a negative value at all pulsing intervals, and the value (−9 ± 13) was significantly lower than that (22 ± 20) in the apical lateral segment at a pulsing interval of 1:8 (p< 0.01). With power Doppler imaging, the background-subtracted videointensity was high even in the basal septal segment (112 ± 33), and no significant difference was observed among each segment.Conclusions: The findings indicate that quantitative assessment of myocardial perfusion based upon background-subtracted videointensity may be difficult in the far field with harmonic gray scale imaging although the attenuation is not apparent by visual analysis. Harmonic power Doppler is more sensitive for detecting basilar perfusion in the far field compared with harmonic gray scale imaging.