继发孔房间隔缺损左心室迹线、波前及心室内相对压的超声血流向量成像评价  

Evaluation of Left Ventricular Pathline, Wavefront and Relative Pressure in Secundum Atrial Septal Defect By Ultrasonic Flow Vector Imaging

作　　者：张键 王庆慧[1] 丁云川[1] 陈剑[1] 侯宗柳[1] 苏璇[1] 李建华[1] 张瑜[1] Zhang Jian;Wang Qinghui;Ding Yunchuan;Chen Jian;Hou Zongliu;Su Xuan;Li Jianhua;Zhang Yu(Department of Ultrasound,Yan′an Hospital Affiliated to Kunming Medical University,Key Laboratory of Cardiovascular Disease of Yunnan Province,Yunnan Clinical Medical Center for Cardiac Disease,Kunming,Yunnan 650051,China)

机构地区：[1]昆明医科大学附属延安医院超声医学科,云南省心血管疾病重点实验室,云南省心脏疾病临床医学中心,昆明市650051

出　　处：《中国超声医学杂志》2020年第7期621-624,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金(No.81460268);云南省卫生科技计划内设研究机构项目(No.2014NS216)。

摘　　要：目的应用血流向量成像新功能评估房间隔缺损(ASD)左室迹线、波前及心室内相对压的变化规律。方法选取继发孔型ASD 94例,分为不伴、轻度、中度、重度肺动脉高压(PAH)组,健康志愿者31例为正常对照组,评估左室迹线、波前及心室内压差(IVPDs)变化规律。结果(1)正常对照组、不伴PAH组、轻度PAH组左室迹线和波前成像均显示舒张期能顺利迅速直达心尖;中度、重度PAH组整体呈漩涡状不能顺利直达心尖;各组流动效率随肺压升高逐渐降低。(2)正常对照组与不伴PAH组各时相下IVPDs大小相近,轻度、中度、重度PAH组IVPDs随肺压升高逐渐降低(P<0.05);各组IVPDs分别与E、e呈正相关,与E/e呈负相关。结论迹线、波前及相对压成像可为定量评估ASD左室流体力学变化、PAH及心功能指数提供新参考。Objective The new function of VFM was used to evaluate the changes of Pathline,Wavefront and Relative Pressure in left ventricle of ASD.Methods 94 patients with ASD were divided into PAH(-),mild PAH,moderate PAH and severe PAH group.31 healthy volunteers served as normal control group.The changes of Pathline,Wavefront and IVPDs were analyzed by VFM.Results(1)The Pathline and Wavefront of the normal control,non PAH and mild PAH group showed that they can reach the apex of the heart smoothly and rapidly;The moderate PAH and severe PAH group can′t reach the apex smoothly in a whirlpool;While the flow efficiency decreases with the increase of pulmonary pressure.(2)The size of IVPDs in the normal control group was similar to the non PAH group at different time phases,but the IVPDs decreases with the increase of pulmonary pressure in the mild,moderate and severe PAH group(P<0.05).The size of IVPDs was positively correlated with E and e respectively and negatively correlated with E/e.Conclusions The Pathline,Wavefront and Relative Pressure Imaging can provide a new reference for quantitative evaluation of ASD left ventricular fluid dynamics,pulmonary pressure and its cardiac function index.

关 键 词：房间隔缺损 肺动脉高压 迹线 波前 相对压成像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.1[医药卫生—诊断学]