Kemper A J, Force T, Kloner R, Gilfoil M, Perkins L, Hale S, Alker K, Parisi A F
Circulation. 1985 Nov;72(5):1115-24. doi: 10.1161/01.cir.72.5.1115.
Contrast echocardiography can predict pathologic area at risk during acute coronary occlusion. In this study we evaluated (1) whether the intensity and timing of contrast appearance in ischemic regions can provide a quantitative measure of residual myocardial perfusion, and (2) whether changes in these parameters observed after serial injections reflect changes in blood flow to acutely ischemic tissue. Supra-aortic hydrogen peroxide contrast echocardiography was performed in 12 consecutive dogs at 1, 20, and 120 min after acute circumflex coronary occlusion. Contrast enhancement was determined qualitatively with a segmental four-point scoring system based on the appearance time and peak perceived intensity of contrast enhancement and quantitatively with a computer algorithm designed to reflect these parameters. Comparison was made in each segment to concomitant radioactive microsphere blood flow. Qualitative scoring related systematically to normalized segmental blood flow (3+ = 93%; 2+ = 61%; 1+ = 32%; 0 = 18%; p less than .01 for each vs adjacent value), as did quantitative analysis including all segments (r = .78; p less than .01) and isolated to the ischemic region (flow = 1.13 intensity change +6.8%; r = .83, p less than .001). Changes in microsphere flow in ischemic regions between sequential observations were correlated with changes in qualitative score (r = .88, p less than .001) and results of quantitative analysis (r = 0.70, p less than .01). The amount of contrast enhancement can provide quantitative information about residual myocardial blood flow in ischemic regions and can also be used to track changing patterns of flow in vivo after acute coronary occlusion.
对比增强超声心动图可预测急性冠状动脉闭塞期间的危险病理区域。在本研究中，我们评估了：（1）缺血区域对比剂出现的强度和时间是否能提供残余心肌灌注的定量测量；（2）连续注射后观察到的这些参数变化是否反映急性缺血组织血流的变化。在12只连续的犬急性冠状动脉回旋支闭塞后1分钟、20分钟和120分钟进行主动脉弓上过氧化氢对比增强超声心动图检查。根据对比增强的出现时间和峰值感知强度，用节段性四点评分系统对对比增强进行定性测定，并使用旨在反映这些参数的计算机算法进行定量测定。将每个节段与同时进行的放射性微球血流进行比较。定性评分与标准化节段血流系统相关（3+ = 93%；2+ = 61%；1+ = 32%；0 = 18%；与相邻值相比，每个p均小于0.01），包括所有节段的定量分析（r = 0.78；p小于0.01）以及仅针对缺血区域的分析（血流 = 1.13×强度变化 + 6.8%；r = 0.83，p小于0.001）也如此。连续观察之间缺血区域微球血流的变化与定性评分变化（r = 0.88，p小于0.001）和定量分析结果（r = 0.70，p小于0.01）相关。对比增强量可提供关于缺血区域残余心肌血流的定量信息，还可用于追踪急性冠状动脉闭塞后体内血流模式的变化。
