Spinnler M T, Cecchi E, Fubini A, Castellano G, Morello P, Bobbio M, Montemurro D, Mancini E, Defilippi G, Orzan F
Cattedra di Malattie dell'Apparato Cardiovascolare, Università degli Studi di Torino.
G Ital Cardiol. 1988 Jun;18(6):456-64.
Thirty-two patients with non acute myocardial infarction (inferior in twenty, anterior in ten, anterior and inferior in two) were studied with contrast left ventriculography, two-dimensional echocardiography and radionuclide angiography to assess left ventricular wall motion. We adopted the CASS criteria for the standard left ventriculography, and the Mayo Clinic classification for the echocardiographic study. Radionuclide angiography studies were obtained in left anterior oblique view; the images were evaluated with the use of Walsh-Hadamard transform; the left ventricle was divided in basal and apical septal, apical, posterolateral, posterobasal and two central segments. We tried to correlate the findings of the three techniques both for single segments and larger regions made of contiguous segments. Left ventricular angiography and two-dimensional echocardiography showed a fair concordance for both anterobasal and posterolateral left ventricular wall, whereas for the septal, apical and posterolateral regions contrast and radionuclide angiography had the best correlation. Compared to left ventricular angiography two-dimensional echocardiography shows better sensitivity than radionuclide angiography; the latter is more specific in defining left ventricular wall motion. The two non invasive techniques are therefore helpful in the evaluation of wall motion and their role is complementary.
对32例非急性心肌梗死患者(下壁20例,前壁10例,前壁合并下壁2例)进行了对比剂左心室造影、二维超声心动图和放射性核素血管造影检查,以评估左心室壁运动。我们采用CASS标准进行标准左心室造影,并采用梅奥诊所分类法进行超声心动图研究。放射性核素血管造影研究采用左前斜位;图像采用沃尔什-哈达玛变换进行评估;左心室分为基底和心尖间隔、心尖、后外侧、后基底和两个中央节段。我们试图将这三种技术在单个节段以及由相邻节段组成的较大区域的检查结果进行关联。左心室造影和二维超声心动图在前基底和左心室后外侧壁的检查结果显示出较好的一致性,而在间隔、心尖和后外侧区域,对比剂造影和放射性核素血管造影的相关性最佳。与左心室造影相比,二维超声心动图的敏感性高于放射性核素血管造影;后者在定义左心室壁运动方面更具特异性。因此,这两种非侵入性技术有助于评估壁运动,它们的作用是互补的。