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目的 探讨心肌背向散射积分 (IBS)对小儿川崎病心室壁缺血的识别和预后评估价值。方法 2 0 0 0年 1月至 2 0 0 3年 12月深圳市儿童医院收治心脏超声显示冠状动脉管壁异常、心肌多普勒组织成像 (DTI)显示节段性运动减弱的川崎病患儿 4 1例 ,对其应用背向散射联机分析技术检测心室壁平均背向散射积分 (AII)和背向散射积分周期性变化幅度 (CVIB) ,分别比较室壁病变节段和非室壁病变节段相同区域急性期和恢复期AII、CVIB值以及心腔血液和心包校正AII值的差别 ,部分病例还做了单光子发射计算机断层摄片术 (SPECT)核素心肌灌注显像检查 ,并做对照分析。结果 4 1例川崎病患儿急性期左室各壁 6 2个缺血节段的平均AII值比恢复期显著增高 (t =2 89,P <0 0 1) ,CVIB值显著性降低 (t =2 12 ,P <0 0 5 ) ;急性期和恢复期均无缺血表现的左室各壁乳头肌水平AII值、CVIB值比较均无显著性差异 (P >0 0 5 ) ,并且IBS方法与DTI、SPECT检测结果比较有高度相关性。结论 心肌背向散射积分可以识别川崎病患儿心肌缺血性病变 ,AII和CVIB参数作为评估指标具有重要的临床意义
Objective To investigate the value of myocardial backscatter integration (IBS) in the identification and prognosis of ventricular wall ischemia in children with Kawasaki disease. Methods From January 2000 to December 2003, Shenzhen Children’s Hospital underwent echocardiography to show abnormalities of coronary artery wall. Myocardial Doppler tissue imaging (DTI) showed that children with Kawasaki disease whose segmental motility was weakened 41 cases were analyzed by backscatter online analysis of ventricular wall average backscatter integral (AII) and backscatter integral cyclical changes (CVIB) were compared between the wall lesions and non-wall lesions section AII and CVIB values in acute and convalescent regions of the same region, as well as differences in AII between pericardial blood and pericardial blood, and in some cases, single photon emission computed tomography (SPECT) myocardial perfusion imaging was performed and Control analysis. Results The mean AII of 6 ischemic segments in 4 children with acute Kawasaki disease was significantly higher than that in convalescence (t = 2 89, P 0 01), while CVIB decreased significantly (t = 2 12, P <0 05). There was no significant difference in AII and CVIB between left and right parietal papillary muscles in both acute phase and convalescent phase (P> 0.05), and IBS Methods and DTI, SPECT test results are highly correlated. Conclusions Cardiac backscatter integration can identify myocardial ischemic lesions in children with Kawasaki disease. AII and CVIB parameters have important clinical significance