应用血流向量成像技术评价正常人左心室室壁剪应力的初步研究  

The Evaluation of the Left Ventricular Wall Shear Stress in Healthy Adult Using Vector Flow Mapping:Preliminary Results

作　　者：杨艳 薛丹 张宇新 邢长洋 袁丽君 段云友 Yang Yan;Xue Dan;Zhang Yuxin;Xing Changyang;Yuan Lijun;Duan Yunyou(Department of Ultrasound Medicine,Tangdu Hospital,the Second Affiliated Hospital of the AirForce Medical University,Xi'an710038,China)

机构地区：[1]空军军医大学第二附属医院唐都医院超声诊断科,西安市710038

出　　处：《中国超声医学杂志》2024年第4期422-426,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用血流向量成像(VFM)技术,评价正常人收缩期左心室壁18节段室壁剪应力(WSS)的变化规律。方法纳入61例健康成人,男性29例,女性32例,并于收缩期各时相(T1:等容收缩期;T2:快速射血期;T3:缓慢射血期)测量左心室各节段WSS,比较其性别之间及各期之间的差异。结果性别之间的差异均无统计学意义(P>0.05),女性左心室整体WSS在T1和T2期略高于男性,在T3期时略低于男性。在各个时期,从基底段到心尖段WSS均呈逐渐减低的趋势。左心室大部分节段WSS T1~T3期呈现逐渐减低趋势且各期之间差异均有统计学意义(P<0.01)。然而左心室WSS在后间隔中间段、前侧壁中间段、前侧壁基底段、前间隔心尖段、前壁心尖段、前壁中间段及前壁基底段仅T1和T3以及T2和T3各期之间差异有统计学意义(P<0.05)。此外,在T1~T3期,前间隔基底段、中间段及后间隔基底段左心室WSS较余室壁各节段显著增高,且呈现出减少-增加-减少的趋势(P<0.01)。结论VFM技术可定量分析不同心动周期左心室壁各个节段WSS的分布。左心室WSS在收缩期呈规律性变化。Objective To evaluate the 18-segment left ventricular(LV)wall shear stress(WSS)during systole in healthy adult using vector flow mapping(VFM).Methods A total of 61 healthy adults(29 males,32 females)were enrolled in this study.WSS of each segment of left ventricle(LV)were measured at three systolic phases(T1:isovolumetric systole phase;T2:rapid ejection phase;T3:slow ejection phase)to evaluate the differences of the sexes and variations across different phases.Results Despite the global LV WSS in females was slightly higher than that in males during T1 and T2 and a little lower in T3,no significant difference was observed(P>0.05).LV WSS showed a decreasing trend from basal to apical segments in each phase.Besides,LV WSS reduced gradually from T1 to T3 in most segments and there were statistical differences between each phase(P<0.01).However,WSS of other segments was found significantly different between T1-T3 and T2-T3 phase,such as middle inferoseptal segment,middle anterolateral segment,basal anterolateral segment,apical anteroseptal segment,apical anterior segment,middle anterior segment,and basal anterior segment(P<0.05).In addition,LV WSS of basal anteroseptal segment,middle anteroseptal segment and basal inferoseptal segment were significantly higher than that of the other segments,and showed a trend of decreasing-increasing-decreasing during T1-T3(P<0.01).Conclusions VFM is a potentially useful tool to quantitatively analyze the distributions of WSS in the different segments of left ventricular wall during the cardiac cycle.LV WSS changes regularly during the systole.

关 键 词：超声心动描记术 血流向量成像 室壁剪应力 左心室 

分 类 号：R54[医药卫生—心血管疾病]