基于超声造影成像的体外门静脉静水压无创评估方法  

Noninvasive assessment of extracorporeal portal hydrostatic pressure based on ultrasound contrast imaging

作　　者：许香怡 郑驰超[2] 王亚丹 马千清 段亚阳 张怡卿 张超学[1] Xu Xiangyi;Zheng Chichao;Wang Yadan;Ma Qianqing;Duan Yayang;Zhang Yiqing;Zhang Chaoxue(Department of Ultrasound,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Biomedical Engineering,Hefei University of Technology,Hefei 230009,China;School of Biomedical Engineering,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学第一附属医院超声科,合肥230022 [2]合肥工业大学生物医学工程系,合肥230009 [3]安徽医科大学生物医学工程学院,合肥230032

出　　处：《中华超声影像学杂志》2024年第10期871-877,共7页Chinese Journal of Ultrasonography

摘　　要：目的探讨在超声造影成像的基础上,通过声波激励微泡造影剂评估体外静水压的价值。方法建立一个体外静水压评估系统,首先评估相同浓度的微泡造影剂在20、25、30、35、40和45 cmH 2O环境压力下造影强度的变化。然后,将初始强度相同的造影剂在不同压力下放置1 s、3 s和5 s,分析造影剂强度变化量百分比,以选择最佳激励时间。最后,使用声波激励设备刺激不同压力下的造影剂,采用Pearson积矩相关系数进行相关性分析,采用线性回归分析,建立不同压力和强度变化量百分比的关系。结果当环境压力在20、25、30、35、40和45 cmH 2O 6种梯度下改变时,随着压力的增加,造影剂强度下降,造影剂强度与压力呈负相关(r=-0.971,P<0.001)。在不同的压力作用下,造影剂强度在1 s内、3 s内、5 s内出现不同程度的下降,各压力梯度下造影剂强度变化量百分比在1 s内差异无统计学意义(P>0.05),而3 s内、5 s内差异有统计学意义(均P<0.05)。微泡造影剂受激励声波刺激1 s后,造影剂强度变化量百分比与环境压力显著相关(r=-0.976,P<0.001)。以刺激1 s后造影剂强度变化量百分比为自变量,压力为因变量,拟合线性回归模型,模型公式为:y=60.075-2.559×x1,其中x1为造影剂变化量百分比(R 2=0.952,P<0.001)。结论声波激励微泡造影剂1 s后,造影剂强度变化量百分比对20、25、30、35、40和45 cmH 2O 6种压力梯度下的静水压具有较好的预测作用,有望为临床医师提供一种无创监测门静脉压的新方法。Objective To investigate the value of using ultrasound excited contrast agents to assess extracorporeal hydrostatic pressure on the basis of ultrasound contrast imaging.MethodsAn extracorporeal hydrostatic pressure evaluation system was established.The changes in contrast intensity was first evaluated for the same concentration of microbubble contrast agent at ambient pressures of 20,25,30,35,40,and 45 cmH 2O.Contrast agents with the same initial intensity were placed at different pressures for 1 s,3 s,and 5 s,and the percentage change in contrast agent intensity was analyzed to select the optimal excitation time.Finally,the contrast agent at different pressures was stimulated using an acoustic excitation device,and correlation analysis was performed using the Pearson product moment correlation coefficient.Linear regression analysis was used to establish the relationship between different pressures and the percentage change in intensity.ResultsWhen the ambient pressure was varied under 6 gradients of 20,25,30,35,40,and 45 cmH 2O,the contrast strength decreased with the pressure increased,and there was a negative correlation between contrast strength and the pressure(r=-0.971,P<0.001).Under different pressures,the contrast agent intensity showed different degrees of natural decrease in 1 s,3 s,and 5 s.The difference in the percentage change in contrast agent intensity in each pressure gradient was not statistically significant in 1 s(P>0.05),whereas the differences in the percentage change in contrast agent intensity in 3 s and 5 s were statistically significant in each pressure gradient(all P<0.05).After microbubble contrast agent was stimulated by ultrasound excitation for 1s,the percentage change in contrast agent intensity was significantly correlated with ambient pressure(r=-0.976,P<0.001).A linear regression model was fitted with the percentage change in contrast agent intensity after 1 s of stimulation as the independent variable and the pressure as the dependent variable,with the model equation:y=60.075-2.

关 键 词：超声微泡造影剂 无创压力评估 门静脉高压 惯性空化 

分 类 号：R445.1[医药卫生—影像医学与核医学]