摘要
本研究采用体外血流模型，模拟连枷样二尖瓣（ＦＭＶ）口返流，应用常规彩色多普勒血流显像（ＣＤＦＩ）的返流面积与射流和血流会聚区的三维（３Ｄ）超声重建及实际返流量进行对比研究，评价更复杂的血流（脉冲血流通过ＦＭＶ）状态３Ｄ重建的可行性和准确性。被驱动的血流通过一个模拟ＦＭＶ口，返流口的截面积为０．２４ｃｍ２。仪器使用ＡＴＬ，ＩｎｔｅｒｓｐｅｃＡｐｏｇｅｅ８００彩色多普勒超声仪，探头附着在一种机械臂上，在ＴｏｍＴｅｃ计算机控制下进行０°～１８０°的旋转扫描获得射流和血流会聚区３Ｄ重建的数据。同时磁带记录ＣＤＦＩ图像待后分析。结果显示：ＣＤＦＩＦＭＶ的返流面积与实际返流容积和最大返流量呈中等相关（ｒ＝０．６９，ＳＥＥ＝２．２ｃｍ２，Ｐ＜０．０５和ｒ＝０．６２，ＳＥＥ＝２．５ｃｍ２，Ｐ＜０．０５）。３Ｄ重建后的返流容积与实际返流容积和最大返流量相关良好（ｒ＝０．９６，ＳＥＥ＝７．６ｍｌ，Ｐ＜０．０５和ｒ＝０．９４，ＳＥＥ＝８．４ｍｌ，Ｐ＜０．０１）。血流会聚区３Ｄ重建与实际返流容积相关较好（ｒ＝０．８９，ＳＥＥ＝０．２２ｍｌ，Ｐ＜０．０１）。结论：３Ｄ重建可减低ＣＤＦＩ的某些限制，如增益、贴壁返流和混叠速度等，特别是?
Objestive The aim of the present study was to evaluate the use of measurements of color Doppler jet area, three dimensional (3D) jet volume and 3D flow convergence region as methods for assessing the possiblity and accuracy of 3D reconstruction of a more complex flow situation: pulsative flow through a simulated flail mitral valve(FMV). Methods: Four different flows (10, 20, 40 and 60 ml/beat) were driven into a previously described flow model using a Harvard Pulsative Blood Pump model. The flow was driven through a disk simulating a flail orifice valve. The cross sectional area of the regurgitant orifice was 0.24 cm 2. The flow convergence towards the orifice and the regurgitant jet were imaged using an ATL/Interspec ultrasound system (Apogee RX 800). The 3D was acquired using a rotation scan strategy with the transducer mounted on a mechanical arm and rotated from 0° to 180°. Under control of a TomTec computer, two dimensional (2D) ultrasound images were recorded on 0.5 inch video tape simultaneously with the rotational acquisition. Results: The correlation between the maximal jet area and the regurgitant volume/beat, the maximal volumetric flow rate were moderate ( r =0.69, SEE=2.2 cm 2, P <0.05; r =0.62, SEE=2.5 cm 2, P <0.05; r =0.71 respectively). A close correlation was found between the 3D reconstruction of the maximal regurgitant jet volume and the maximal volumetric flow rate ( r =0.96, SEE=7.6 ml, P <0.05). Similar results were found when the jet volume was compared to the regurgitant volume/beat and the driving velocity ( r =0.94, SEE=8.4 ml, P <0.01). There was a significant correlation between the volume of the flow convergence and the regurgitant volume/beat, the maximal volumetric flow rate ( r =0.89, SEE=0.22 ml, P <0.01). Conclusion: The result of the 3D reconstruction of regurgitant jet are superior to 2D maximal jet areas. However, 3D reconstruction of flow event are encumbered with the limitation of 2D Color Doppler i. e, gain settings. Central jets v
关键词
连枷二尖瓣
三维重建
超声心动图
mitral valve,flail three dimensional reconstruction echocardiography,Doppler
