血流向量成像技术量化观察急性下壁心肌梗死患者舒张期左心室涡流特征  

Vector Flow Mapping of Left Ventricular Diastolic Dynamics in Patients with Acute Myocardial Infarction

作　　者：刘蕊 纳丽莎[2] 刘丽文[3] 马斌[3] 郭建英[3] 

机构地区：[1]鹪煤集团总医院,河南鹤壁458000 [2]宁夏医科大学总医院心功能检查部,宁夏银川750004 [3]第四军医大学西京医院超声诊断科,陕西西安710032

出　　处：《中国医学影像学杂志》2012年第9期680-683,共4页Chinese Journal of Medical Imaging

基　　金：陕西省社发攻关计划项目(2010K15-01-01)

摘　　要：目的采用血流向量成像技术分析急性下壁心肌梗死患者舒张期左心室内血流动力学的变化特征。资料与方法对60例正常人和35例急性下壁心肌梗死患者行超声心动图检查,采集标准心尖三腔心切面连续3个心动周期的彩色血流动态图像。采用血流向量成像技术的涡流模式进行脱机分析,测量并比较舒张期左心室内涡流横径、纵径,涡流横向位置、纵向位置,涡流的最大向量速度及涡流强度。结果与正常人比较,急性下壁心肌梗死患者缓慢充盈期与左心房收缩期涡流纵径明显增大(P<0.01),横向位置更靠近后侧壁,纵向位置靠近心尖部,最大向量速度、涡流强度均明显减低(P<0.01)。结论血流向量成像显示急性下壁心肌梗死患者缓慢充盈期与左心房收缩期左心室内血流动力学具有特征性,为评估左心室内流体力学提供了一个全新的技术手段。Purpose To explore the diastolic flow dynamics of left ventricle （LV） using vector flow mapping （VFM） in patients with inferior wall myocardial infarction and normal control. Materials and Methods Thirty-five patients with inferior wall myocardial infarction and sixty normal control were examined by two-dimensional echocardiography. The apical three-chamber color Doppler images were obtained and analyzed off-line with VFM. The longitudinal length, horizontal length, transverse position, vertical position, maximum speed, strength of vortex in LV during diastole were measured. The differences between patients with inferior wall myocardial infarction and normal control were compared. Results In slow filling phase and left atrial systolic phase, longitudinal diameter was larger in patients with AMI （P 〈 0.01）; transverse position was closer to posterior wall of LV; vertical position was closer to LV apex. The vortex maximum speed and strength of vortex were reduced （P 〈 0.01）. Conclusion Vortex longitudinal length, transverse position, vertical position, maximum speed, strength of vortex were different between normal control and patients with inferior wall myocardial infarction. The shape and position of vortex were changed. VFM may serve as a new approach to estimating hemodynamics of the heart.

关 键 词：心肌梗死 超声心动描记术 血流向量成像技术 心室功能 左 血流动力学 

分 类 号：R542.22[医药卫生—心血管疾病] R445.1[医药卫生—内科学]