二尖瓣血流传播速度估测左心室舒张功能影响因素的研究  

Study on affecting factors of propagation velocity of mitral flow for evaluating left ventricular diastolic function

作　　者：陈笋[1] 陈树宝[1] 孙锟[1] 张玉奇[1] 江海[1] 郁怡[1] 张志芳[1] 倪金红[1] 高玲玲[1] 沈蓉[1] 

机构地区：[1]上海第二医科大学附属新华医院上海儿童医学中心心内科,200127

出　　处：《中华超声影像学杂志》2004年第4期261-265,共5页Chinese Journal of Ultrasonography

摘　　要：目的　探讨超声心动图色彩反转速度及切面选择对二尖瓣血流传播速度 (Vp)测定结果的影响。方法　在 3 3例先天性心脏病患儿中 ,分别于心尖四腔及二腔观采集二尖瓣血流的彩色M型图像。应用自行设计的计算机辅助测量系统 (CAMS)测量二尖瓣血流传播速度。分别在四腔及二腔观选取 3种不同的感兴趣色彩测定血流传播速度 (Vp)。所有患者均进行心导管检查 ,并将超声测得二尖瓣血流传播速度与心导管参数进行比较。结果　所有患者中 ,由心尖四腔及二腔观图像所获得的Vp之间差异无显著性意义。在 3 3例先天性心脏病患者中 ,不同切面及不同感兴趣色彩所测得的Vp之间差异无显著性意义。不同切面与不同感兴趣色彩所测得的Vp均与左心室舒缓时间常数 (τ)显著相关。当设定处理色彩代表较高的血流速度时 ,Vp与τ之间的相关性更好。结论　CAMS系统可准确地估测二尖瓣血流传播速度以反映左心室舒张功能。切面观选择对血流传播速度的选择无显著影响 ,在检测中应选定代表较高血流速度的感兴趣色彩。Objective To determine whether and how the propagation velocity of mitral flow(Vp) is influenced by different aliasing limits or different echo views.Methods The color M-mode Doppler images of mitral flow were obtained in 33 patients with congenital heart disease in apical four chamber and two chamber view. These images were transferred to HP EnConcert workstation for further study. The hue and brightness of each pixel in the region of interest(ROI) could be recognized by the CAMS. After defining the ROI and color of interest(COI),the CAMS identified the first appeared pixel which had the same hue and brightness in every depth(horizontal axis).These pixel were regressed into a straight line, then the slop of the line representing Vp was obtained. To clarify the affecting factors,six different COI were selected for measuring Vp on images taken from apical 2 and 4 chamber view. Cardiac catheterization examination was performed in all the patients. In the coronary artery disease patients, the spectrum of mitral flow was also detected with pulsed Doppler echocardiography. All the results of non-invasive examination were compared with the indexes from cardiac catheterization. Results In the all patients, there was no significant difference between the Vp measured on images taken from apical 2 chamber view and Vp from apical 4 chamber view(P= 0.52, 0.99 and 0.47 in 1/3,2/3 and aliasing limit). In the 33 congenital heart disease patients,no significant difference existed among Vps′ measured with different views and different COIs′. Vps measured on images taken from different views and different COIs′ by the CAMS significantly correlated with τ(P= 0.89). When the COI representing higher velocity was selected, the correlation between Vp and τ would be much taller. Conclusions The CAMS could correctly estimate Vp for evaluating left ventricular diastolic function in congenital heart disease patients. Echo views showed no significant influence on Vp measuring. The COI representing higher velocity should b

关 键 词：二尖瓣血流传播速度 左心室舒张功能 影响因素 超声心动图 小儿 先天性心脏病 

分 类 号：R445.1[医药卫生—影像医学与核医学]