无创性定量左室心腔内涡流的方法及临床应用  

Noninvasive methods to quantify the vortex in the left ventricular chamber and clinical applications

作　　者：张家芬[1] 李澎[1] 

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院超声科,北京100037

出　　处：《中国分子心脏病学杂志》2010年第2期118-122,共5页Molecular Cardiology of China

摘　　要：定量观察左室腔内涡流,可以评价左室的收缩功能和舒张功能。涡流的形态及位置随心功能减低而发生变化。已经证实,MRI及超声心动图均能够准确观测左室内的涡流。虽然观测方法仍存在一些局限性,借助声学造影的超声心动图方法是能够用于临床的最为准确有效的技术。该方法利用声学微泡流动与涡流的一致性特征对心室重构及心肌做功进行定量研究。敏感参数包括涡流深度比(0.482±0.06)、长度比(0.467±0.05)、宽度比(0.128±0.06)、球形指数(3.66±0.6)、相对强度比(2.10±0.8)、涡流的相对强度(1.19±0.5)和脉动相关系数(1.31±0.5);舒张早期涡流半径(3±1mm)、舒张早期充盈血流前锋速度Vp(47±6cm/s)及Vp/E(0.59±0.07)。但是,由于临床试验研究对象的例数较少,临床应用效果仍缺乏相应的循证医学的依据。Quantitative analysis of the vortex in left ventricular （LV） chamber during cardiac cycles can be used to evaluate LV systolic and diastolic functions. The variations of vortical shape and location have been described following LV functional decreases. It has been proved that MRI and eehocardiography are beth feasibly able to assess cardiac flow patterns. However, limitations of this this technique remains unsolved although echocardiography has been evaluated as a promising modality in clinic pavilions by using contrast agents. Quantification of ventricular reconstruction and myocardial pumping function is able to be achieved using echo contrast microbubbles. Vortex parameters have been validated as sensitive predictors of LV functions, such as average vortex depth （ VD, 0. 482 ± 0.06 ）, vortex length （ VL, 0.467 ± 0. 05 ）, vortex width （ VW, 0. 128 ±0.06）, spherical index（Sl, 3.66 ±0. 6）, relative strength（2.10 ±0. 8）, vortex relative strength （VRS, 1.19 ± 0.5 ）and vortex pulsation correlation （1.31 ± 0. 5 ） ; vortex radius in the early diastolic phase （ VR, 3 ± 1 mrn）, the velocity of filling flow front Vp （ 47 ± 6 em/s ） and Vp/E （ 0.59 ± 0. 07 ）. But, broadbased clinical trials on relative applications are still required to provide epidemiological evidences.

关 键 词：心腔内涡流 声学造影 超声涡流成像 

分 类 号：R540.4[医药卫生—心血管疾病]