VFM技术评价慢性肾功能不全患者左心室舒张功能的研究  

Evaluation of Left Ventricular Diastolic Function in Chronic Renal Failure Patients by Vector Flow Mapping

作　　者：孔双双 李玲[1] 谢明星[1] 李玉曼[1] 王艺[1] 刘曼薇[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科,武汉市430022

出　　处：《中国超声医学杂志》2016年第4期310-313,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用血流向量成像(VFM)技术分析慢性肾功能不全(CRF)患者舒张期左室血流流场特征,探讨其在评价CRF患者左室舒张功能中的价值。方法 30例CRF者和32例健康成人行超声心动图检查,VFM成像模式下采集心尖三腔心切面彩色血流动态图像。应用DAS-RS1软件观察和对比分析左室腔舒张期血流变化。结果与正常组比较,CRF患者舒张期左室腔血流流场分布不均,涡流数目增多、形态不一、方向紊乱、强度增加。CRF组左室腔各节段舒张期峰值流速(DVmax)、峰值流量(Fd)、舒张期正向流量(DQ+)、舒张期总流量(DQtotal)增加,二尖瓣下方涡量(Vmax)、涡流面积(Vor.A)及循环(Circu)增加。CRF组基底段DQtotal与血肌酐(Scr)、血尿素氮(Bun)呈正相关,与肾小球滤过率(GFR)呈负相关,E/e′与基底段DVmax、Fd及二尖瓣后叶下方涡量(P-Vmax)呈正相关。结论 CRF患者左心室血流流场发生变化,尤以涡流变化显著,VFM技术为评价其左室腔内血流流场变化特征及左室舒张功能改变提供了一种新方法。Objective To analysis left ventricular diastolic hemodynamic characteristics in patients with chronic renal failure（CRF）,and discuss the application value of the vector flow imaging（VFM）technique in assessment of left ventricular diastolic function in CRF patients.Methods 30 CRF patients and 32 healthy adults were enrolled.LV intracardiac flow dynamic images were recorded by VFM in the apical three-chamber view.The diastolic blood flow were observed and compared using the DAS-RS1off-line software.Results Compared with the control group,the left ventricular diastolic blood flow field were less uniform,the number of vortexes were increased,the shapes were more disordered and vorticities were higher in CRF patients.Values of DVmax,Fd,DQ＋,DQtotal of each segment and Vmax,Vor.A,Circu under mitral valves were significantly higher.There existed positive correlation between DQtotal at basal level with Scr,Bun and negative correlation with GFR,and positive correlation between E/e′with DVmax,Fd at basal level and P-Vmax.Conclusions There exists changes of left ventricle diastolic flow field,especially the vortex in CRF patents.VFM could provide a new method in evaluation of left ventricular blood flow field characteristics and diastolic function in CRF patients.

关 键 词：慢性肾功能不全 血流向量成像 涡流 左室 

分 类 号：R540.45[医药卫生—心血管疾病]