血流向量成像技术对心肌梗死室壁瘤患者血流动力学的研究  

Study on hemodynamics of ventricular aneurysm with myocardial infarction by vector flow mapping

作　　者：崔玲妹 王岳恒[1] 马立衡 白晖[1] 王伟[1] Cui Lingmei;Wang Yueheng;Ma Liheng;Bai Hui;Wang Wei(Department of Cardiac Ultrasound,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Cardiology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院心脏超声科,石家庄050000 [2]河北医科大学第二医院心内科,石家庄050000

出　　处：《中华超声影像学杂志》2021年第4期287-293,共7页Chinese Journal of Ultrasonography

摘　　要：目的利用血流向量成像(vector flow mapping,VFM)技术观察室壁瘤患者左室能量损耗(energy loss,EL)及心尖段室壁剪应力(wall shear stress,WSS)的变化特点。方法收集室壁瘤患者27例,依据左室心尖部是否合并血栓将其分为室壁瘤组(16例)和室壁瘤血栓组(11例);同时收集健康体检者20例作为对照组。测量受检者心室结构及心功能参数,脱机进行VFM离线分析,根据时间-流量曲线及瓣膜的启闭划分为收缩期和舒张期,获取相应的EL及WSS并进行组间比较。结果①舒张期和收缩期,室壁瘤组与室壁瘤血栓组左室心尖段的EL低于对照组,差异有统计学意义(均P<0.05)。②舒张期,室壁瘤组与室壁瘤血栓组间隔心尖段、侧壁心尖段、前壁心尖段的WSS峰值低于对照组(均P<0.05),室壁瘤组前壁心尖段的WSS均值低于对照组(P<0.05)。③收缩期,室壁瘤组与室壁瘤血栓组前壁心尖段的峰值WSS低于对照组,室壁瘤组前壁心尖段的WSS均值低于对照组(均P<0.05);室壁瘤血栓组前壁心尖段的WSS均值高于室壁瘤组(P<0.05)。结论VFM技术可以定量评价左室室壁瘤患者的EL和WSS,为进一步了解左室伴或不伴血栓的室壁瘤患者心腔内血流动力学提供新的视角。Objective To observe the changes of left ventricular energy loss(EL)and apical wall shear stress(WSS)in patients with ventricular aneurysm by using vector flow mapping(VFM).Methods Twenty-seven patients with ventricular aneurysm were selected as the case group,and they were divided into the ventricular aneurysm group(16 cases)and ventricular aneurysm thrombus group(11 cases)according to whether the apex of the heart was accompanied by thrombosis.Twenty healthy people were collected as the control group.Ventricular structure and cardiac function parameters were measured and the VFM offline analysis was performed.Systolic and diastolic phases were determined based on time-flow curve(T-F curve)and the open-close of valves,the corresponding left ventricular energy loss and the parameters of the WSS of the apex segment of the heart were obtainedand then compared between groups.Results①In diastolic and systolic phases,EL values of left ventricular apical segment in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than that in control group(all P<0.05).②In diastolic phase,the peak WSS values of septal apical,lateral apical and anterior apical segments in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than those in control group(all P<0.05),and the mean WSS of anterior apical segment in aneurysm group was lower than that in control group(P<0.05).③In systolic phase,the peak WSS values of anterior wall in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than those in control group,and the mean WSS of anterior wall in ventricular aneurysm group was lower than that in control group(all P<0.05).The mean WSS of anterior wall in ventricular aneurysm thrombus group was higher than that in ventricular aneurysm group(P<0.05).Conclusions VFM technology can quantitatively evaluate the EL and WSS of patients with left ventricular aneurysm,and provide a new perspective for further understanding of intracardiac hemodynamics in patients with l

关 键 词：血流向量成像技术 左室室壁瘤 血栓 能量损耗 室壁剪应力 

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