血流向量成像对冠心病患者左室腔内舒张期涡流的定量评价

Quantitative evaluation on left ventricular diastolic vortex flow of patients with coronary artery disease using vector flow mapping

目的应用血流向量成像(VFM)技术探讨冠心病患者左室腔内舒张期涡流状态的特点。方法 43例冠心病患者(冠心病组)和35例健康志愿者(对照组)分别接受常规超声心动图检查,采集连续3个心动周期的标准心尖三腔观彩色血流动态图像,应用VFM软件DSA-RS1进行脱机分析,测量舒张中期左室腔内涡流横径、纵径、圈数及涡流强度,观察舒张期涡流演变过程,比较两组间的差异。结果与对照组比较,冠心病组舒张期涡流位置更靠近二尖瓣环,涡流形态不规则,疏密不均匀,舒张中期涡流橫径、纵径减小[(25.46±9.18)mmvs.(32.39±11.32)mm,P﹤0.01;(23.45±10.65)mm vs.(35.04±12.66)mm,P﹤0.01],圈数减少[(8.09±2.99)vs.(9.51±3.28),P﹤0.05],涡强显著降低[(18.90±6.42)s-1vs.(26.40±9.24)s-1,P﹤0.01]。结论 VFM技术能直观显示冠心病患者左室腔内血液流场状态结构,可用于初步定量评价冠心病患者心室腔内血流动力学变化,为评价心腔内血流结构的研究提供了一种新的方法。

Objective To quantitatively analyze left ventricular diastolic vortex flow of coronary artery disease （CAD） patients using vector flow mapping （VFM）. Methods Forty-three CAD patients （ CAD group） and 35 healthy volunteers （control group ） were involved in. After routine echocardiography, the apical three-chamber color Doppler images in three sequent cardiac cycles were saved and analyzed off-line with VFM DSA-RS1 software. Parameters of the left ventricular mid-diastolic vortex including the transverse diameter,vertical diameter,number of the vortices and vortex relative strength index were measured, and the changing process of the diastolic vortex was observed. The differences between the two groups were compared. Results Compare with the control group, the location of the left ventricular diastolic vortex was closer to the mitral annular, the shape and density were more variable in CAD group. Transverse diameter and vertical diameter of the mid-diastolic vortex in CAD group were decreased [ （25.46± 9.18）mm vs. （32.39 ± 11.32）mm,P 〈 0.01 ; （23.45 ± 10.65）mm vs. （ 35.04 ± 12.66）mm, P 〈 0.011. The number of the vortices was decreased [ （8.09 ±2.99） vs. （9.51 ± 3.28 ）,P 〈 0.05 ]. The vortex relative strength index of the control group was significantly decreased in CAD group [ （18.90 ± 6.42）s-1 vs. （26.40 ± 9.24）s-1,P 〈 0.01 ]. Conclusion The distribution of the left ventricular vortex flow of CAD patients can be visualized by eehoeardiography using VFM technique ,which is potentially used to be an alternative method to evaluate the hemodynamic changes of the CAD patients in cardiac chambers.