VFM技术评价扩张型心肌病患者左心室腔内血流

作者:智光[1] 周肖[1] 徐勇[2] 童锴[3] 
单位:中国人民解放军总医院(301医院)[1]
北京解放军301医院[2]
中国人民解放军301医院[3]
   目的 用VFM(Vector Flow Mapping,向量血流成像)技术评价扩张型心肌病患者左心室腔内血流变化。    方法 随机入选临床明确诊断的扩张型心肌病患者及正常志愿者,应用VFM成像技术采集心尖三腔、五腔切面图像,定量分析心动周期各期左心室腔内基底段、中间段、心尖段各平面的血流速度,并进行两组间的比较。   结果 共入选扩张型心肌病患者6名及正常对照组11名,两组之间比较,扩心病患者收缩期左室流出道血流速度明显低于正常组;扩心病组左心室中间段和心尖段存在朝向心尖方向的血流,而正常组则没有;等容收缩期左心室腔内基底段血流速度正常组高于扩心病组,而中间段、心尖段血流速度扩心病组高于正常组。   结论 扩张型心肌病患者左心室流出道血流速度减低,且存在收缩期等容收缩期心腔内血流的紊乱,VFM技术可以用于检测左心室腔内血流的改变。 Evaluation of Intraventricular Flow in DCM patients Using Vector Flow Mapping   Aims To assess the change of intraventricular flow due to DCM (Dilated Cardiomyopathy) using VFM(Vector Flow Mapping).   Methods DCM patients and healthy candidates were included into 2 groups. 3C and 5C images were stored using VFM. Vector velocity of intraventricular flow was measured at the different planes and compared among groups.    Results 6 DCM patients and 11 candidates were included. The vector velocity measured at LV outflow tract is lower in DCM group; a flow in direction of LV apex was found in the middle and apical planes of DCM patients while not in healthy candidates; the vector velocity of isovolumic contraction measured at basal plane is found to be higher in healthy group, but lower in the same group at middle and apical planes.   Conclusions Iin DCM patients, the vector velocity of LVOT is lower, which is accompanied by an abnormal flow distribution in middle and apical parts of left ventricle in both systole and isovolumic contraction. VFM can be used to evaluate the change of the intraventricular blood flow.
图1健康志愿者收缩期心腔内血流
图2 扩心病患者收缩期心腔内血流  左心室中间段、心尖段可见朝向心尖血流

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