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目的探讨双嘧达莫负荷超声背向散射积分(简称背散积分,IBS)技术诊断川崎病心肌缺血和损伤的价值。方法2007～2008年利用超声背散积分的方法观察31例有冠状动脉损伤的川崎病患儿,全部病例在静息和潘生丁负荷后都经历了超声检查,测量前间壁(AS)、左室后壁(PW)和下壁(INF)3个节段的IBS周期变化(CV),测值与铊-201(Thallium-201,Tl-201)核素心肌扫描结果比较,评价IBS诊断川崎病心肌缺血和损伤的价值。结果静息状态下,Tl-201心肌扫描正常和异常节段的CVIBS均无明显变化。负荷后,核素异常分布节段CV明显的下降。负荷后延迟的研究表明全部病例CV都恢复到静息状态水平。与Tl-201心肌扫描比较,在PW和INF节段,CVIBS的敏感性分别是75%和91%,特异性分别是91%和90%。结论双嘧达莫负荷CVIBS方法可定量评估川崎病患儿心肌缺血或损伤的严重性,为评价预后提供了一个敏感的检查方法。
Objective To investigate the value of dipyridamole load ultrasonic backscatter integration (IBS) in the diagnosis of myocardial ischemia and injury in Kawasaki disease. Methods From 2007 to 2008, 31 children with Kawasaki disease with coronary artery injury were observed by ultrasonic backscatter integration. All patients underwent ultrasound examination after resting and dipyridamole stress. The mean anterior wall (AS), left ventricular The changes of IBS in three segments of wall (PW) and inferior wall (INF) were compared with those of Thallium-201 (Tl-201) The value of ischemia and injury. Results At rest, there was no significant change in CVIBS between Tl-201 myocardial infarction and abnormal segment. After loading, the anomalous distribution of radionuclides CV decreased significantly. Studies after the load delay showed that CV was restored to resting levels in all cases. The CVIBS sensitivity was 75% and 91%, respectively, in the PW and INF segments, with a specificity of 91% and 90%, respectively, as compared to the Tl-201 myocardial scan. Conclusions The dipyridamole-loaded CVIBS method can quantitatively assess the severity of myocardial ischemia or injury in children with Kawasaki disease and provide a sensitive method for evaluating prognosis.