使用瞬态响应二次谐波成像技术，通过一次静脉注射微泡，在多个超声心动图窗口检测心肌灌注。

Detection of myocardial perfusion in multiple echocardiographic windows with one intravenous injection of microbubbles using transient response second harmonic imaging.

作者信息

Porter T R, Li S, Kricsfeld D, Armbruster R W

机构信息

University of Nebraska Medical Center, Omaha 68198-2265, USA.

出版信息

J Am Coll Cardiol. 1997 Mar 15;29(4):791-9. doi: 10.1016/s0735-1097(96)00575-x.

DOI:10.1016/s0735-1097(96)00575-x

PMID:9091526

Abstract

OBJECTIVES

The purpose of this study was to prove that transient response harmonic imaging could detect normal and abnormal myocardial perfusion in multiple echocardiographic windows with one intravenous injection of microbubbles in humans.

BACKGROUND

Myocardial ultrasound contrast can be produced from intravenous perfluorocarbon-exposed sonicated dextrose albumin, and ultrasound can be significantly improved by briefly suspending the interval between frame rates. Whether this contrast can noninvasively quantify myocardial perfusion in humans is unknown.

METHODS

In 28 patients, harmonic transient response imaging was used to image the heart in multiple different imaging planes after one intravenous injection of ultrasound contrast agent. Twenty-five of these 28 patients had a repeat injection during dipyridamole stress. In the primary view, the ultrasound transmission rate was one frame per cardiac cycle; in secondary and tertiary views, the transmission rate was once every multiple cardiac cycles. Regional myocardial contrast was visually assessed and quantified off-line. Quantitative rest thallium and dipyridamole stress sestamibi imaging was also performed.

RESULTS

Perfusion abnormalities were evident in the secondary and tertiary views only with one frame every multiple cardiac cycles. Regional peak myocardial videointensity (PMVI) correlated closely with regional tracer uptake in individual patients both at rest (r = 0.84) and during stress (r = 0.88). A PMVI ratio (abnormal region divided by the region with highest nuclear uptake) < 0.6 in any view had a 92% sensitivity and a 84% specificity in identifying a regional nuclear perfusion abnormality.

CONCLUSIONS

Transient response imaging produces myocardial contrast in multiple views with one intravenous injection of contrast agent and can accurately identify regional myocardial perfusion abnormalities.

摘要

目的

本研究旨在证明，在人体中通过静脉注射一次微泡，瞬态响应谐波成像可在多个超声心动图窗口中检测正常和异常的心肌灌注。

背景

心肌超声造影可由静脉注射经全氟碳暴露的超声处理的葡萄糖白蛋白产生，并且通过短暂暂停帧率间隔可显著改善超声效果。这种造影剂能否在人体中无创地定量心肌灌注尚不清楚。

方法

对28例患者在静脉注射一次超声造影剂后，使用谐波瞬态响应成像在多个不同成像平面上对心脏进行成像。这28例患者中有25例在双嘧达莫负荷试验期间重复注射。在主视图中，超声传输速率为每个心动周期一帧；在副视图和第三视图中，传输速率为每多个心动周期一次。对局部心肌造影进行视觉评估并离线定量。还进行了静息铊和双嘧达莫负荷试验锝-99m甲氧基异丁基异腈成像。

结果

仅在每多个心动周期一帧的副视图和第三视图中可见灌注异常。在个体患者中，静息时（r = 0.84）和负荷试验期间（r = 0.88），局部心肌视频强度峰值（PMVI）与局部示踪剂摄取密切相关。在任何视图中，PMVI比值（异常区域除以核摄取最高的区域）< 0.6在识别局部核灌注异常方面具有92%的敏感性和84%的特异性。