血流向量成像评估继发孔房间隔缺损右心室能量损耗的研究  

Evaluation of Right Ventricular Energy Loss in Secondary Pore Atrial Septal Defect by Velocity Flow Mapping

作　　者：张瑞华[1] 霍亚玲 郑彬 刘杨[1] Zhang Ruihua;Huo Yaling;Zheng Bin;Liu Yang(Department of Ultrasound,Children's Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China;Department of Radiology,Children's Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院郑州儿童医院超声医学科,郑州市450000 [2]郑州大学附属儿童医院、河南省儿童医院郑州儿童医院医学影像科,郑州市450000

出　　处：《中国超声医学杂志》2025年第3期287-290,共4页Chinese Journal of Ultrasound in Medicine

基　　金：2022年河南省医学科技攻关联合共建项目(No.LHGJ20220762)。

摘　　要：目的 应用血流向量成像(VFM)研究继发孔房间隔缺损(ASD)的右心室血流流场特征。方法 收集继发孔ASD患儿60例(观察组),根据肺动脉压力分为肺动脉高压(PAH)组(26例)及无PAH组(34例),同时期健康儿童60例(对照组),利用VFM分析手术前后右心室血流分布及右心室能量损耗(RVEL)。结果 (1)对照组、无PAH组及PAH组常规参数比较:术前各组右心室面积变化率(RVFAC)、三尖瓣环收缩期位移(TAPSE)、三尖瓣E/A、e/a逐渐减小,肺动脉内径、Tei指数逐渐增大,差异均有统计学意义(P<0.05);术后3个月复查,PAH组与无PAH组的RVFAC、TAPSE、E/A、e/a较术前均明显升高,肺动脉内径、Tei指数均明显降低,与对照组比较差异无统计学意义(P>0.05)。(2)各组VFM参数比较:对照组、无PAH组涡流多出现在三尖瓣口附近,PAH组在右心室腔内亦出现涡流,术前不同时相下观察组右心室涡流面积、涡流数量、循环强度及RVEL明显高于对照组,且与肺动脉压力呈正相关(P<0.01);术后各组间右心室涡流面积、涡流数量、循环强度及RVEL比较差异无统计学意义(P>0.05)。(3)RVEL与右心功能参数的相关性:RVEL分别与右心室涡流面积、涡流数量、循环强度,Tei指数呈正相关,与RVFAC、TAPSE呈负相关(P<0.05)。结论 VFM可定量评估右心室血流分布及能量损耗变化,从心脏负荷角度敏感地反映ASD患儿心腔血流流场特征。Objective To investigate the hemodynamic flow field characteristics of the right ventricle in patients with acquired atrial septal defect(ASD)using the velocity flow mapping(VFM).Methods Sixty patients with sec-ondary ASD(observed group)were collected,divided into two groups according to pulmonary artery pressure:no pul-monary artery hypertension(PAH)group(34 cases)and pulmonary artery hypertension(PAH)group(26 cases),and 4o healthy children in the same period were selected as the control group.The right ventricular blood flow distri-bution and right ventricular energy loss(RVEL)were analyzed using VFM technology before and after surgery in the observed group.Results OComparison of conventional parameters between the control group,no PAH group,and PAH group:Before surgery,the RVFAC,TAPSE,E/A,and e/a of each group gradually decreased,while the inter-nal diameter of the pulmonary artery and Tei index gradually increased,with significant differences(P<0.05);After 3-month follow-up,the RVFAC,TAPSE,E/A,and e/a of the PAH group and no PAH group were significantly higher than those before surgery,while the internal diameter of the pulmonary artery and Tei index were significantly lower than those of the control group,with no significant differences between the two groups(P>0.05).@Compari-son of VFM parameters between the groups:Before surgery,the vortex flow in the control group and no PAH group was mainly located near the tricuspid valve,while the vortex flow in the PAH group was also located in the right ven-tricular cavity.Before surgery,the turbulent flow area,number of vortices,circulation intensity,and RVEL of the observed group were significantly higher than those of the control group,and were positively correlated with the pul-monary artery pressure(P<0.O1);After surgery,there was no statistically significant difference in the turbulent flow area,number of vortices,circulation intensity,and RVEL between the groups(P>0.05).③RVEL is positively correlated with right ventricular vortex area,vortex number,circulati

关 键 词：房间隔缺损 血流向量成像 临床价值 

分 类 号：R725.4[医药卫生—儿科]