摘要
目的:探讨全新的向量血流成像技术(vector flow imaging technique,V Flow)测量的血管壁应力(wall shear stress,WSS)在评估兔腹主动脉早期动脉粥样硬化(atherosclerosis,AS)中的价值。方法:选用健康雄性新西兰兔7只,高脂饮食喂养建立兔腹主动脉AS模型。喂养14周后,每周采用常规灰阶超声观察兔腹主动脉管壁是否有硬化斑块形成,采用彩色多普勒血流图(color Doppler flow imaging,CDFI)测量腹主动脉血流量(blood flow volume,BFV)及收缩期峰值流速(peak systolic velocity,PSV),采用V Flow观察并测量兔腹主动脉前、后壁WSS值。34周后,以病理检查结果为金标准,对比并分析WSS在兔腹主动脉AS形成及发展过程中的动态变化。结果:病理结果显示,高脂饮食喂养34周后兔腹主动脉出现AS脂纹期的典型改变,37周后兔腹主动脉有AS纤维斑块的表现。腹主动脉前、后壁WSS随着AS病程的进展动态变化:从14周开始呈降低趋势,20/21周至27周表现为增高趋势,27周之后又逐渐降低。腹主动脉前壁和后壁WSS最大值(WSSmax)、WSS平均值(WSSmean)的拐点值与第0周基线值差异具有统计学意义(P<0.05),WSSmax、WSSmean变化曲线出现拐点的时间早于常规CDFI测得的PSV及BFV值。结论:V Flow较传统的CDFI可更早预测腹主动脉AS斑块及评估相应血流动力学改变,具有潜在的临床应用价值。
Objective:To explore the change of wall shear stress(WSS)parameter measured by vector flow imaging technology(V Flow)in evaluation of the early hemodynamic changes of aorta atherosclerosis(AS)in rabbit models.Methods:AS models were established by feeding high fat forage in healthy New Zealand rabbits(n=7).After 14 weeks of feeding,the formation of atherosclerotic plaque on the wall of rabbit abdominal aorta was observed by conventional gray-scale ultrasound,the blood flow volume(BFV)and peak systolic velocity(PSV)were measured by color Doppler flow imaging(CDFI),and V Flow was used to observe and measure the anterior and posterior wall WSS values of the rabbit aorta,then once a week.After 34 weeks of feeding,the pathological examination results were used as the gold standard to compare and analyze the dynamic changes of WSS in the formation and development of AS.Results:The pathological results showed that typical fatty streak changes of AS on the wall of rabbit aorta after 34 weeks of high-fat diet,and AS fibrous plaques appeared in the abdominal aorta of rabbits after 37 weeks.The dynamic changes of the anterior and posterior wall of the abdominal aorta with the progression of the AS course were as follows:from 14 weeks,it showed a decreasing trend,from 20/21 to 27 weeks,it showed an increasing trend,and after 27 weeks it gradually decreased.The inflection point values of the WSSmaximum(WSSmax)and WSS average(WSSmean)of the anterior and posterior walls of the abdominal aorta were significantly different from the baseline value at week 0(P<0.05).The inflection points of WSSmax and WSSmean curves were earlier than the PSV and BFV values measured by conventional CDFI.Conclusions:Compared with traditional CDFI,V Flow can predict as plaque and evaluate hemodynamic changes in abdominal aorta,which has potential clinical application value.
作者
邱艺杰
董怡
何婉媛
张琪
张炜彬
杨道辉
朱宇莉
曹佳颖
毛枫
王文平
QIU Yi-jie;DONG Yi;HE Wan-yuan;ZHANG Qi;ZHANG Wei-bin;YANG Dao-hui;ZHU Yu-li;CAO Jia-ying;MAO Feng;WANG Wen-ping(Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Institute of Medical Imaging,Shanghai 200032,China)
出处
《中国临床医学》
2020年第3期438-443,共6页
Chinese Journal of Clinical Medicine
基金
国家自然科学基金(81501471)
上海市科学技术委员会“科技创新行动计划”临床医学领域项目(17411954200)
上海市科学技术委员会医学引导类项目(18411967200)
上海市卫生和计划生育委员会科研课题计划资助(201840215)
上海市临床重点专科项目经费资助(shslczdzk03501).
