摘要
目的利用经胸冠状动脉血流显像技术研究左前降支(LAD)心肌桥患者的壁冠状动脉血流频谱特征以及硝酸甘油对血流频谱的影响;探讨应用经胸冠状动脉血流显像技术诊断心肌桥的可行性。方法取32例冠状动脉造影检出的心肌桥患者作为研究对象,其中31例心肌桥位于LAD中段,1例位于远段,静息及舌下喷服硝酸甘油后观察壁冠状动脉及其近、远端彩色多普勒及频谱多普勒特点,比较壁冠状动脉与其近、远端血流参数及诱发前后壁冠状动脉血流参数。结果硝酸甘油诱发前后LAD中段彩色多普勒总显示率87.1%。静息状态12例患者壁冠状动脉段出现特征性的“拇指征”频谱,列为静息阳性组,诱发后出现“拇指征”频谱的10例患者列为诱发阳性组。诱发前彩色多普勒检出1例壁冠状动脉起始处舒张期花色血流,诱发后增加显示6例,其中1例出现收缩期反向蓝色血流,多普勒检查示诱发前后拇指征频谱与其近、远端比较舒张期峰值流速、舒张期平均流速、加速度差异有统计学意义;诱发前后“拇指征”频谱比较舒张期峰值流速、舒张期平均流速、加速度差异有统计学意义,壁冠状动脉受压时间差异无统计学意义。诱发后2例测及收缩期反向波频谱。结论经胸冠状动脉血流显像技术是诊断心肌桥的一种新方法,应用硝酸甘油可提高心肌桥的检出率。
Objective To study Doppler characters of the mural coronary artery（MCA） of subjects with myocardial bridgings in coronary artery left anterior decending（LAD） by transthoracic color Doppler coronary flow imaging（CDCFI） and the effect on coronary flow by using nitroglycerin; to explore the feasibility of diagnosing for myocardial bridging by CDCFI. Methods Thirty-two patients with myocardial bridging confirmed by coronary angiogram, myocardial bridging lay in LAD middle segment in 31 of them, one in distal segment, the characters of color Doppler flow and pulsed-wave Doppler（PW） of within, proximal to and distal to MCA were observed before and after Nitrolingual-Spray, the flow parameters of MCA were compared to that of proximal to and distal to MCA; the flow parameters of MCA before and after induction were compared also. Results The total display percentage of middle segment of LAD before and after induction was 87. 1%. Twelve patients who displayed the characteristic finger-tip profile of MCA in rest condiction were listed into rest positive group; ten who displayed this phenomenon after induction were listed into induction positive group. One patient showed diastolic mosaic blood signal in the initiation of MCA in rest and 6 after induction, one of them showed systolic reverse blue signal. Diastolic peak velocity （DPV）,average diastolic peak velocity（ADPV） and diastolic acceleration ratio（DAR） of the finger-tip profile showed significant difference to that of proximal and distal segments before and after induction respectively. As for finger-tip profile before and after induction, DPV, ADPV, DAR showed significant difference, the squeezing time of MCA（Tac） showed insignificant difference; two patients showed systolic reverse pulsed wave after induction. Conclusions CDCFI is a new method to diagnose myocardial bridging, the positivity can be raised by using nitroglycerin.
出处
《中华超声影像学杂志》
CSCD
2006年第9期646-650,共5页
Chinese Journal of Ultrasonography
基金
北京市自然科学基金资助项目(7042023)
