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目的应用选择性心肌超声造影(MCE)及定量组织多普勒对冠状动脉介入治疗(PCI)后病变心肌灌注及收缩功能变化进行研究。方法20例行PCI的患者,于PCI前后经冠状动脉内注入造影剂SonoVue,应用MCE观察心肌显影效果、造影剂显影途径,定量分析心肌灌注情况;应用定量组织多普勒测量病变心肌收缩功能变化。结果注入造影剂后心肌清晰显影,患者术前MCE造影剂充盈情况与冠状动脉造影证实病变区域一致,冠状动脉成功开通患者术后即刻MCE显示缺血节段充盈较术前显著改善;6例患者观察到少量造影剂经心肌直接漏入左室腔;定量组织多普勒提示冠状动脉成功开通的患者病变心肌运动位移、应变改善。结论选择性MCE能满意显示心肌灌注状态,并能观察到缺血心肌局部微循环与心室腔直接相通;PCI即刻可以改善心肌局部微循环及局部心肌功能。
Objective To study the changes of myocardial perfusion and systolic function after coronary artery interventional therapy (PCI) by selective myocardial contrast echocardiography (MCE) and quantitative tissue Doppler. Methods Twenty patients undergoing PCI were injected with SonoVue via intracoronary injection of PCI before and after PCI. Myocardial imaging and contrast imaging were used to observe myocardial perfusion. Multivariate myocardial Doppler was used to measure myocardial contractile function . Results After the contrast medium was injected, the myocardium was clearly developed. The preoperative filling of MCE contrast agent was consistent with that of coronary artery angiography. The MCE of the successful coronary artery opening showed a significant improvement of ischemic segment filling compared with that before operation. Six patients A small amount of contrast agent was observed to leak directly into the left ventricular cavity through the myocardium. Quantitative tissue Doppler imaging showed that the myocardial motion was improved and the strain was improved in patients with successfully opened coronary arteries. Conclusions Selective MCE can show myocardial perfusion satisfactorily, and local microcirculation of ischemic myocardium can be observed to be directly connected with ventricular cavity. PCI can improve myocardial microcirculation and local myocardial function immediately.