Yamada Satoshi, Komuro Kaoru
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Curr Opin Cardiol. 2006 Sep;21(5):433-7. doi: 10.1097/01.hco.0000240578.05053.f9.
Ultrasonic tissue characterization is a non-invasive diagnostic method that uses myocardial integrated backscatter analysis to determine contractile performance and myocardial viability independent of wall motion. This review discusses recent clinical findings regarding the application of ultrasonic tissue characterization for the assessment of myocardial viability.
As this technique is non-invasive, ultrasonic tissue characterization can be used to predict the patency of infarct-related arteries in patients in the early stage of acute myocardial infarction. Several recent studies have shown that this technique is useful in identifying myocardial contractile reserve. The accuracy of ultrasonic tissue characterization for predicting functional recovery after coronary reperfusion is comparable to dobutamine echocardiography and radionuclide methods. Several studies have suggested that the cyclic variation of myocardial integrated backscatter reflects myocardial viability rather than contractile reserve. The cyclic variation of integrated backscatter is associated with myocardial viability confirmed by the integrity of the microvasculature identified by contrast echocardiography. In addition, the cyclic variation of integrated backscatter better reflects myocardial viability confirmed by the integrity of cellar metabolism than contractile reserve.
Ultrasonic tissue characterization with integrated backscatter is a useful non-invasive method that can provide unique information for the assessment of myocardial viability.
超声组织特性分析是一种非侵入性诊断方法,它利用心肌背向散射积分分析来确定收缩功能和心肌存活性,而不依赖于室壁运动。本综述讨论了关于超声组织特性分析在评估心肌存活性方面应用的近期临床研究结果。
由于该技术是非侵入性的,超声组织特性分析可用于预测急性心肌梗死早期患者梗死相关动脉的通畅情况。近期的几项研究表明,该技术在识别心肌收缩储备方面很有用。超声组织特性分析预测冠状动脉再灌注后功能恢复的准确性与多巴酚丁胺超声心动图和放射性核素方法相当。几项研究表明,心肌背向散射积分的周期性变化反映的是心肌存活性而非收缩储备。背向散射积分的周期性变化与经对比超声心动图确定的微血管完整性所证实的心肌存活性相关。此外,与收缩储备相比,背向散射积分的周期性变化能更好地反映由细胞代谢完整性所证实的心肌存活性。
背向散射积分的超声组织特性分析是一种有用的非侵入性方法,可为评估心肌存活性提供独特信息。