Yang Lixia, Mu Yuming, Quaglia Luiz Augusto, Tang Qi, Guan Lina, Wang Chunmei, Shih Ming Chi
Department of Image Center, Xuhui Central Hospital, Shanghai 200031, China.
J Biomed Biotechnol. 2012;2012:806731. doi: 10.1155/2012/806731. Epub 2012 Jun 13.
The study aim was to compare two different stress echocardiography interpretation techniques based on the correlation with thrombosis in myocardial infarction (TIMI ) flow grading from acute coronary syndrome (ACS) patients. Forty-one patients with suspected ACS were studied before diagnostic coronary angiography with myocardial contrast echocardiography (MCE) at rest and at stress. The correlation of visual interpretation of MCE and TIMI flow grade was significant. The quantitative analysis (myocardial perfusion parameters: A, β, and A × β) and TIMI flow grade were significant. MCE visual interpretation and TIMI flow grade had a high degree of agreement, on diagnosing myocardial perfusion abnormality. If one considers TIMI flow grade <3 as abnormal, MCE visual interpretation at rest had 73.1% accuracy with 58.2% sensitivity and 84.2% specificity and at stress had 80.4% accuracy with 76.6% sensitivity and 83.3% specificity. The MCE quantitative analysis has better accuracy with 100% of agreement with different level of TIMI flow grading. MCE quantitative analysis at stress has showed a direct correlation with TIMI flow grade, more significant than the visual interpretation technique. Further studies could measure the clinical relevance of this more objective approach to managing acute coronary syndrome patient before percutaneous coronary intervention (PCI).
本研究旨在基于与急性冠状动脉综合征（ACS）患者心肌梗死溶栓治疗（TIMI）血流分级的相关性，比较两种不同的应力超声心动图解读技术。41例疑似ACS患者在诊断性冠状动脉造影前，于静息和负荷状态下接受心肌对比超声心动图（MCE）检查。MCE的视觉解读与TIMI血流分级的相关性显著。定量分析（心肌灌注参数：A、β和A×β）与TIMI血流分级也显著相关。MCE视觉解读与TIMI血流分级在诊断心肌灌注异常方面具有高度一致性。若将TIMI血流分级<3视为异常，则静息状态下MCE视觉解读的准确率为73.1%，敏感性为58.2%，特异性为84.2%；负荷状态下准确率为80.4%，敏感性为76.6%，特异性为83.3%。MCE定量分析具有更好的准确性，与不同水平的TIMI血流分级的一致性达100%。负荷状态下MCE定量分析与TIMI血流分级呈直接相关，比视觉解读技术更显著。进一步研究可衡量这种更客观的方法在经皮冠状动脉介入治疗（PCI）前管理急性冠状动脉综合征患者中的临床相关性。
