Zusammenfassung
Nach Injektion Mikroluftbläschen enthaltender Lösungen ins Blut läßt sich ihre Passage durch die myokardiale Mikrozirkulation echokardiographisch als Myokardopazifizierung erfassen. Dieses Phänomen bildet die Grundlage der Myokard-Kontrastechokardiogra-phie, die so eine Beurteilung der Myokardperfusion erlaubt. Bisher wurde diese Methode zwar auch klinisch angewendet, blieb aber im wesentlichen wissenschaftlichen Fragestellungen vorbehalten, da ausreichende Myokardopazifizierung nur nach intrakoronarer Kontrastinjektion erzielt werden konnte. Die Entwicklung stabilerer und lungenkapillar-gängiger Echokontrastmittel, neuer 2-D-echokardiographischer und Doppler Verfahren (wie harmonic imaging oder Power Doppler) sowie die Verwendung der intermittierenden Bildgebung (30) haben die Technik der Myokard-Kontrastechokardiographie in letzter Zeit wesentlich verbessert. So erfuhr die Methode die entscheidende Erweiterung ihres klinischen Potentials: zunächst tierexperimentell konnte diagnostisch verwertbare Myokardopazifizierung nach venöser Injektion von Echokontrastmittel erzielt werden (8, 10). Erste klinische Studien bestätigen die Bedeutung dieser vielversprechenden Ergebnisse: Die venöse Kontrastechokardiographie wird als Alternative zu den klassischen nuklearmedizinischen Verfahren der myokardialen Perfusionsbeurteilung denkbar (21). Darüberhinaus verbesserten sich aber auch die Möglichkeiten bei arterieller Kontrastgabe: Nach Aorten-wurzelinjektion (die anders als die direkte intrakoronare Applikation die simultane Beurteil-barkeit von Myokardsegmenten unterschiedlicher Gefäßversorgung erlaubt) waren experimentell quantitative Ergebnisse mit sehr guter Bildqualität erzielbar (7).
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© 1998 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt
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Firschke, C. (1998). Myokard-Kontrastechokardiographie: Experimentelle Ergebnisse und klinisches Potential. In: Gehring, J., von Bibra, H. (eds) Echokardiographische Diagnostik bei koronarer Herzkrankheit. Steinkopff. https://doi.org/10.1007/978-3-642-86473-5_16
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