Williams M J, McClements B M, Picard M H
Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston 02114, USA.
J Am Coll Cardiol. 1995 Dec;26(7):1741-6. doi: 10.1016/0735-1097(95)00378-9.
This study was performed to determine whether intravenous injection of a sonicated albumin echocardiographic contrast agent (Albunex) improved the quality of the transthoracic pulmonary venous flow Doppler signal.
Previous studies have shown that transesophageal echocardiography provides pulmonary venous flow Doppler signals superior in quality to those seen with transthoracic echocardiography, which are of limited quality in up to 25% of patients.
Twenty-one patients underwent transthoracic pulsed wave Doppler examination of pulmonary venous flow before, during and after two doses of Albunex ranging from 0.08 ml/kg (low dose) to 0.22 ml/kg (high dose). In addition, five patients underwent transesophageal examination of pulmonary venous flow before and after a 0.08-ml/kg dose of Albunex. The efficacy of the contrast injection was determined using a score that graded the quality of the three components of the pulmonary venous Doppler signal from 0 to 3 (0 = no visible signal; 3 = optimal signal).
Albunex enhanced the quality of the pulmonary venous Doppler signal from baseline (score 3.9 +/- 1.8 [mean +/- SD]) and at both low (score 5.1 +/- 2.2, p < 0.05) and high doses (score 5.6 +/- 2, p < 0.001). Transthoracic pulmonary venous flow velocities were increased, and peak flow velocity ratios were unchanged, after injection of contrast agent. The contrast-enhanced variables showed good agreement with transesophageal flow velocities.
Albunex improves the quality of the transthoracic pulmonary venous Doppler signal, thus allowing improved accuracy of measurement. This approach appears to be effective for increasing the quality of data obtained from the transthoracic examination.
本研究旨在确定静脉注射经超声处理的白蛋白超声心动图造影剂（Albunex）是否能改善经胸肺静脉血流多普勒信号的质量。
先前的研究表明，经食管超声心动图所提供的肺静脉血流多普勒信号质量优于经胸超声心动图，在高达25%的患者中，经胸超声心动图的信号质量有限。
21例患者在注射两剂剂量范围从0.08 ml/kg（低剂量）至0.22 ml/kg（高剂量）的Albunex之前、期间和之后接受了经胸肺静脉血流脉冲波多普勒检查。此外，5例患者在注射0.08 ml/kg剂量的Albunex之前和之后接受了经食管肺静脉血流检查。使用一个评分来确定造影剂注射的效果，该评分将肺静脉多普勒信号的三个成分的质量从0到3进行分级（0 = 无可见信号；3 = 最佳信号）。
Albunex使肺静脉多普勒信号质量从基线水平（评分3.9 ± 1.8 [均值 ± 标准差]）提高，在低剂量（评分5.1 ± 2.2，p < 0.05）和高剂量（评分5.6 ± 2，p < 0.001）时均如此。注射造影剂后，经胸肺静脉血流速度增加，而峰值流速比未改变。造影剂增强后的变量与经食管血流速度显示出良好的一致性。
Albunex改善了经胸肺静脉多普勒信号的质量，从而提高了测量的准确性。这种方法似乎对于提高经胸检查所获数据的质量是有效的。
