Objective:To detect the clinical value of estimating myocardial viability by regional isovolumic myocardial contraction motion indices during quiescent condition.Methods:To measure the regional myocardial motion indices during isovolumic contraction period in normal subjects and patients with OMI by Doppler tissue imaging combined with NTG99mTc-MIBI myocardial perfusion imaging.Results:The results showed that Vs,VIVC1 and DIVC in patients with OMI was significantly decreased and VIVC2,TIVC2 and VTIIVC2 was significantly increased than those of the normal subjects(P0.05).Longitudinal axis DIVC values were only correlated with VF,not with LVEDD,LVEDP,LVEF and FS.Conclusion: DIVC values could not only differentiate viable myocardium but also estimate the degree of myocardial viablity.

Objective To detect new indices of left ventricular regional systolic function with Doppler tissue imaging(DTI) by measuring local myocardial wall motions during isovolumic contraction period in patients with old myocardial infarction(OMI).Methods Thirty normal subjects and 20 patients with OMI were studied.The sample volumes were located at left ventricular postero-septal,lateral,anterior,inferior,antero-septal and posterior walls in basal and middle segments separately.The peak positive and negative myocardial wall motion velocities(VIVC1,VIVC2),times(TIVC1,TIVC2),velocity time integrals(VTIIVC1,VTIIVC2)and the difference(DIVC) between VIVC1 and VIVC2 were measured.Results The wall motion velocities in normal subjects showed that VIVC1>VIVC2,TIVC1>TIVC2,VTIIVC1>VTIIVC2(P<0.05)at every segments besides posterior wall.In the patient group,VIVC1 and DIVC were significantly decreased and VIVC2、TIVC2 and VTIIVC2 were significantly increased in infracted zones than those in the normal subjects(P<0.05~0.01).In contrast,TIVC1 and VTIIVC1 were stable(P>0.05).There were no significant differences in above-mentioned indices(P>0.05)between normal subjects and non-infarcted walls in patients.Conclusions Most DTI indices of myocardial isovolumic contractive motions in infarcted zones in patients with OMI had significant changes,which could be a new method for assessing left ventricular regional systolic function.

国外学者早在20世纪70年代就提出心肌梗死(myocardial infraction, MI)区域内存在存活的心肌(viable myocardium).80年代后的研究进一步证实存活心肌由冬眠心肌(hibernating myocardium )和(或)顿抑心肌(stunned myocardium )所组成.

目的 探讨载瘤动脉短暂按压及瘤内凝血酶注射治疗外周动脉假性动脉瘤(PSA)的价值.方法 在超声引导下对19例外周动脉PSA患者行PSA之载瘤动脉上游侧局部按压及凝血酶注射术.结果 19例患者均为一次治疗成功,瘤腔容积为0.13～34.17 cm3,平均(16±13)cm3;术中使用凝血酶约100～1000 IU,平均(313±150)IU.无载瘤动脉血栓形成或栓塞等并发症发生.结论 超声引导下载瘤动脉按压及凝血酶注射治疗外周动脉PSA是一种新的无痛苦,价格便宜,成功率高,可能减少载瘤动脉血栓形成或栓塞等并发症发生的新方法.

目的 应用多普勒组织成像(DTI)技术测量二尖瓣环等容收缩期速度波(IVC)的系列指标,探讨其评价心肌梗死患者左心室整体收缩功能的价值.方法 应用DTI技术检测30例正常人和20例陈旧性心肌梗死患者二尖瓣环心肌长轴等容收缩期速度波的系列指标,取样容积分别置于心尖四腔切面、心尖两腔切面上的二尖瓣环间隔壁、侧壁、前壁和下壁,测量等容收缩期正向波的峰值速度(VIVC1)、负向波的峰值速度(VIVC2),计算正负向峰值速度的差值(DIVC)及各点均值.结果 陈旧性心肌梗死患者各点的VIVC1均较对照组减小(P＜0.05) ,VIVC2较对照组增大(P＜0.05),以前壁、间隔壁为著.陈旧性心肌梗死患者二尖瓣环各点VIVC1的均值(VIVC1-M)、DIVC的均值(DIVC-M)与应用Simpson法所测左室射血分数有良好的相关性(r=0.68,P＜0.05;r=0.75,P＜0.01).结论 DTI技术所测二尖瓣环等容收缩期的系列速度指标可作为评价陈旧性心肌梗死患者左室整体收缩功能的新指标。