Yao Jiefen, Takeuchi Masaaki, Teupe Claudius, Sheahan Malachi, Connolly Raymond, Walovitch Richard C, Fetterman Robert C, Church Charles C, Udelson James E, Pandian Natesa G
Cardiovascular Imaging and Hemodynamic Laboratory Division of Cardiology, Department of Medicine, New England Medical Center, Tufts University School of Medicine, Boston, USA.
J Am Soc Echocardiogr. 2002 Jul;15(7):686-94. doi: 10.1067/mje.2002.119114.
A new intravenous contrast agent, AI-700, was evaluated to determine whether a bolus injection could be used to detect myocardial perfusion abnormalities during acute ischemia by using 2-dimensional (2D) and 3-dimensional (3D) myocardial contrast echocardiography.
2D MCE was performed in 14 closed-chest dogs during coronary occlusion by using both continuous and triggered gray scale harmonic imaging and triggered power Doppler imaging. 3D MCE (open-chest) and nuclear perfusion imaging were performed in 10 of the 14 dogs. Postmortem triphenyl tetrazolium chloride (TTC) staining was performed to verify infarction.
Thirteen of the 14 dogs had infarct by TTC; all 10 that had nuclear imaging showed a perfusion defect. Of the 13 dogs that had infarction, perfusion defects were detected in all (13 of 13) by gray scale harmonic imaging (sensitivity = 100%), and in 11 of 13 by power Doppler imaging (sensitivity = 85%). All 10 dogs that had nuclear imaging showed perfusion defects by gray scale harmonic imaging (sensitivity = 100%) and 8 of 10 by power Doppler imaging (sensitivity = 80%). The perfusion defect size, derived from 3D imaging (25% +/- 12%) correlated well with that from nuclear imaging (24% +/- 12%) (y = 0.9x + 3.8, r = 0.96, mean difference = 1.3% +/- 2.6%). The perfusion defect mass by 3D (22 +/- 14 g) also correlated well with the infarct mass by TTC staining (24 +/- 16 g) (y = 0.8x + 2.9, r = 0.89, P <.001, mean difference = -2.8 +/- 7.6 g).
After a single bolus of AI-700, both 2D and 3D MCE could accurately detect perfusion defects representing the area at risk of infarction during acute ischemia compared with nuclear imaging and predicted the size of infarction as verified by TTC staining.
对一种新型静脉造影剂AI - 700进行评估，以确定是否可通过团注注射，利用二维（2D）和三维（3D）心肌对比超声心动图来检测急性缺血期间的心肌灌注异常。
对14只开胸犬在冠状动脉闭塞期间进行2D心肌对比超声心动图检查，采用连续和触发式灰阶谐波成像以及触发式能量多普勒成像。对14只犬中的10只进行了3D心肌对比超声心动图检查（开胸）和核灌注成像。进行死后三苯基氯化四氮唑（TTC）染色以验证梗死情况。
14只犬中有13只经TTC染色显示梗死；所有10只进行核成像的犬均显示灌注缺损。在13只发生梗死的犬中，所有犬（13/13）通过灰阶谐波成像检测到灌注缺损（敏感性 = 100%），13只中有11只通过能量多普勒成像检测到（敏感性 = 85%）。所有10只进行核成像的犬通过灰阶谐波成像均显示灌注缺损（敏感性 = 100%），10只中有8只通过能量多普勒成像显示（敏感性 = 80%）。由3D成像得出的灌注缺损大小（25%±12%）与核成像得出的大小（24%±12%）相关性良好（y = 0.9x + 3.8，r = 0.96，平均差异 = 1.3%±2.6%）。3D灌注缺损质量（22±14 g）也与TTC染色的梗死质量（24±16 g）相关性良好（y = 0.8x + 2.9，r = 0.89，P <.001，平均差异 = -2.8±7.6 g）。
单次团注AI - 700后，与核成像相比，2D和3D心肌对比超声心动图均可准确检测出代表急性缺血期间梗死危险区域的灌注缺损，并预测经TTC染色验证的梗死大小。
