计算机辅助彩色M型超声心动图无创估测肺血管阻力的研究

Study on the noninvasive estimation of pulmonary vascular resistance by color M-mode echocardiography assisted with computer

目的 评价自行设计的计算机软件辅助彩色M型超声心动图无创估测肺血管阻力（PVR）的可行性及准确性。方法20例先天性心脏病患者和20例正常儿童为研究对象，应用彩色M型超声心动图检测肺动脉血流传播速度（VPE）并进行比较；应用自行设计的计算机软件测量先心病患者的肺动脉血流传播速度（VPC），并与右心导管技术所测的PVR对比。结果先天性心脏病患者彩色M型超声测得的VPE明显低于正常儿童[（38．38±18．89）cm／s对（80．34±15．65）cm／s，P〈0．01]，且与心导管所测的PVR值显著相关（r=-0．69，P〈0．01）。计算机软件测得VPC与PVR高度相关（r=-0．78，P〈0．01），且重复性较好。VPC〈35．910预测PVR〉16 kPa·s·L^-1的灵敏性为92．9％，特异性为100％。结论 应用计算机辅助彩色M型超声心动图技术测量肺动脉血流传播速度可以比较准确地无创估测肺血管阻力。

Objective To determine the feasibility and accuracy of velocity propagation within main pulmonary artery（VP） from color M-mode Doppler imaging using custom software on a personal computer for noninvasive estimation of PVR. Methods Color M-mode imaging of pulmonary flow was obtained and thin transferred to computer, the velocity propagation of pulmonary flow was automatically obtained. Comparatiw studies among Doppler echocardiography, personal computer and cardiac catheterization for predicting PVR had been done in 20 children with congenital heart disease and 20 normal children. Results Velocity propagations o： children with congenital heart disease were significant lower than those of normal children obtained by color M- mode echocardiography[（38.38 ± 18.89） cm/s vs （80. 34 ± 15.65） cm/s, P 〈0.01], and correlated well with invasive PVR measurements（ r = -0.69, P〈01.01）. The correlation and repeatability of VP obtained by the custom software were better than VP obtained by Doppler echocardiography （ r = - 0.78, P （0. 01）. A VP cutoff value obtained by the custom software of 35. 910 had a sensitivity of 92.90% and a specificity of 100% to determine PVR〉16 kPa . s . L^-1. Conclusions PVR could be accurately estimated by the velocity propagatior within pulmonary artery obtained by color M-mode eehoeardiography using custom software on a persona computer.