| 孙钦亮,赵冰冰,董立平,田家玮.血流向量成像技术评价不同程度舒张功能受损患者左心室舒张期流体变化[J].中国医学影像技术,2020,36(2):235~241 |
| 血流向量成像技术评价不同程度舒张功能受损患者左心室舒张期流体变化 |
| Vector flow mapping evaluation on changes of left ventricular diastolic fluid in patients with different degrees of diastolic impairment |
| 投稿时间：2019-02-18 修订日期：2019-12-29 |
| DOI：10.13929/j.issn.1003-3289.2020.02.015 |
| 中文关键词: 心室功能,左 能量损耗 血流向量成像技术 |
| 英文关键词:ventricular function,left energy loss vector flow mapping |
| 基金项目: |
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| 中文摘要: |
| 目的 应用血流向量成像技术（VFM）评价不同程度舒张功能受损患者左心室血流动力学改变特征，观察能量损耗（EL）的临床应用价值。方法 根据舒张功能受损状况将126例冠心病患者分为Ⅰ、Ⅱ、Ⅲ组3组，正常对照组80名（N组），以VFM观察其速度向量图、流线图演变特征，比较各组间EL差异，分析E/e'与EL的相关性。结果 ①N组和Ⅰ组速度向量图、流线图较Ⅱ、Ⅲ组涡流形态规则，而Ⅱ、Ⅲ组散乱；②Ⅱ组与N组P2（减慢充盈期）与P3（房缩期）中间段与基底段总能量损耗（TEL）、P2中间段与基底段平均损耗（AEL）、P3各节段AEL差异均有统计学意义（P均<0.05）；Ⅲ组与N组P0（等容舒张期）、P1（快速充盈期）基底段AEL、P1各节段AEL差异均有统计学意义（P均<0.05）；③Ⅰ组、Ⅱ组在P1及P3基底段AEL、P3中间段与基底段TEL、P1中间段与基底段AEL差异均有统计学意义（P均<0.05）；Ⅱ组与Ⅲ组各时相基底段TEL、P0中间段与基底段AEL、P1各节段AEL、P2基底段AEL、P3中间段与基底段AEL差异均有统计学意义（P均<0.05）；④Ⅰ、Ⅱ、Ⅲ组P1各段、P0、P2与P3基底段左心室TEL与E/e'均呈正相关（P均<0.05），P1、P3中间段与基底段AEL与E/e'均呈正相关（P均<0.05），P0、P2基底段的AEL与E/e'均呈正相关（P均<0.05）；⑤EL各时相各节段诊断左心室舒张功能受损具有一定准确性。结论 VFM技术可直观显示左心室舒张期流体EL变化，对评价左心室舒张功能受损程度具有重要意义。 |
| 英文摘要: |
| Objective To observe the characteristics of left ventricular hemodynamic changes in patients with different degrees of diastolic dysfunction by using vector flow mapping (VFM), and to explore the clinical value of energy loss (EL) in evaluating the degree of diastolic dysfunction. Methods A total of 126 patients with coronary heart disease were divided into group Ⅰ, Ⅱ and Ⅲaccording to the grade of diastolic dysfunction, while 80 healthy subjects were enrolled in normal control group (group N). The evolution characteristics of velocity vector map and streamline map were observed, EL were compared among groups, and the correlation between E/e' and EL was analyzed. Results ①The velocity vector map and streamline map of group N and Ⅰ were relatively regular, while in group Ⅱ and Ⅲ were scattered. ②Statistical significant differences of total energy loss (TEL) of middle segment and basal segment were found in group Ⅱ and N in P2 and P3 (all P<0.05). The average energy loss (AEL) of middle segment and basal segment in P2 and AEL of every segment in P3, TEL of basal segment in group Ⅲ and N in P0 and P1 as well as AEL of every segment in P1 were all statistically different (all P<0.05). ③There were significant differences between Ⅰ and Ⅱ in AEL of basal segment in P1 and P3, and in TEL of middle segment and basal segment in P3, also in AEL of middle segment and basal segment in P1 (all P<0.05). There were significant differences between Ⅱ and Ⅲ in AEL of basal segment in every period, AEL of middle segment and basal segment in P0, AEL of every segment in P1, AEL of basal segment in P2, AEL of middle segment and basal segment in P3. ④Positive correlations were observed between E/e' and TEL of every segment in P1, basal segment in P0, P2 and P3 (all P<0.05). E/e' and AEL of middle segment and basal segment in P1 and P3 were positively correlated (all P<0.05), of basal segment in P0 and P2 were also positively correlated (all P<0.05). ⑤Diagnosing left ventricular diastolic dysfunction in each phase and segment with EL had certain accuracy. Conclusion VFM can visually display changes of left ventricle EL during diastole, being of great significance for evaluation on the degree of impairment of left ventricular diastolic function. |
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