Studies on Selective Imaging of Coronary Territories Using Intravenous Myocardial Contrast Echocardiography

我们澄清了微泡壳的脆弱性和血流速度的范围之间的关系，在破坏微泡的破坏的完全性方面的流动模型研究。在患者研究中，我们建议在一个会话中分别评估左（LCA）和右冠状动脉（RCA）区域，因为整个心肌节段很少同时浑浊。微泡破坏和补充原理有助于判断冠状动脉狭窄程度。在犬实验中，我们在主动脉根部的短轴图像上显示左冠状动脉主干（LMT），而左心室的短轴视图或长轴视图用另一个换能器显示。连续波多普勒模式的微泡破坏和低功率脉冲反转谐波模式（实时成像）的灌注成像过程中注入BR 1的LMT的声照射是合适的，以获得可观的图像，而微泡破坏显着影响信号强度在LCA的领土。然而，问题仍然没有得到解决;临床上唯一可用的微泡Levovist太脆弱，不适合实时成像，以及在有限的回波窗口中同时处理两个换能器的技术问题。我们发现微循环中微泡的破坏导致毛细血管破裂，导致微出血，导致局部白细胞浸润。然后，我们进一步研究了这一现象，发现微泡附着在活化的白细胞上并被吞噬，这为炎症的超声成像提供了依据。此外，我们发现，因此招募的白细胞（巨噬细胞）产生血管内皮生长因子，从而增强血管生成。

We clarified the relationship between the fragility of microbubble shell and the range of blood flow velocity in destroying the microbubbles regarding the completeness of destruction in a flow model study. In patients study, we propose to evaluate the left (LCA) and right coronary (RCA) territories separately in a session, because the entire myocardial segments are rarely opacified at one time. Microbubble destruction and replenishment principle was useful to determine the severity of coronary stenosis. In dog experiments, we visualized the left main coronary trunk (LMT) on a short axis image of aortic root while the short axis view or the long axis view of the left ventricle was visualized with another transducer. Insonation of LMT with continuous wave Doppler mode for the microbubble destruction and low power pulse inversion harmonic mode (real-time imaging) for perfusion imaging during infusion of BR1 was suitable to obtain appreciable images while microbubble destruction significantly affected the signal intensity in LCA territory. However, problems remained unsolved ; the only microbubble clinically available Levovist is too fragile and is not suitable for real-time imaging, and technical issue to handle two transducers simultaneously in a limited echo window.We further studied the safeness of microbubble destruction. We found that destruction of microbubbles in a microcirculation causes capillary rupture resulting in microhemorrhage leading to local infiltration of leukocytes. Then, we further studied this phenomena and found that microbubbles attach to the activated leukocytes and are phagocytosed, which provided the basis for ultrasonic imaging of inflammation. In addition, we found that thus recruited leukocytes (macrophages) produce vascular endothelial growth factor, thereby enhance angiogenesis.