超声血流向量成像评价心肌梗死患者左心室节段性血流结构变化的研究

摘要

Objective To evaluate the flow structure changes of left ventricular myocardial infarction segments by vector flow mapping (vector flow mapping ,VFM ) and to provide the basis for the diagnosis of myocardial infarction .Methods We selected 42 cases of old myocardial infarction from January 2012 to may 2013 May in our hospital as the study group , and 30 healthy subjects as control group .VFM was used to evaluate blood flow parameters of groups .Results No signifi-cant differences between the two groups in age ,body surface area ,heart rate ,EDV ,ESV of study group were significant-ly higher than that in control group ( P > 0 .05) .LVEF was significantly lower than that of the control group ( P <0.01) .The systolic left ventricular long axis ,apical four chamber of each segment of TF peak time between too groups were no significant difference ( P >0 .05) ,the diastolic left ventricular long axis ,apical four chamber of each segment of TF peak time in the sludy group was significantly longer than that of the control group ( P<0 .05) .The systolic segmen-tal positive flow ,total flow rate ,positive negative total flow and total flow rate were shown no statistical difference ( P>0 .05) ,the diastolic basal segment ,middle segment positive flow ,total flow and total flow rate in the sludy group was sig-nificantly lower than that of control group ( P<0 .05) .Conclusion VFM can image in any fault ,evaluate multiple range of the heartbeat cycle arbitrary phase changes in blood flow to the heart of each section ,offer a more comprehensive under-standing on the flow structure of heart in patients with myocardial infarction ,and provide a strong basis for diagnosis , prognosis and rehabilitation of patients with myocardial infarction condition .%目的：应用血流向量成像技术（vector flow mapping ，VFM ）评价心肌梗死左心室各节段血流结构变化情况，为心肌梗死诊断提供依据。方法选择2012年1月～2013年5月我院收治的陈旧性心肌梗死患者42例作为研究组，并选择同期门诊体检健康对照者30例作为对照组。应用V FM 测量血流参数。结果两组年龄、体表面积、心率比较无统计学差异（ P ＞0．05），研究组舒张末期容积（end-diastolicvolume ，EDV ）、收缩末期容积（end-systolic volume ，ESV ）显著高于对照组，左心室射血分数（left ventricular ejection fraction ，LVEF）显著低于对照组（ P ＜0．01）。两组收缩期左心长轴、心尖四腔各节段TF达峰时间比较无统计学差异（ P ＞0．05），研究组舒张期左心长轴、心尖四腔各节段 TF达峰时间显著长于对照组（P ＜0．05）。两组收缩期各节段正向流量、正向总流量、负向总流量和总流量比较无统计学差异（P ＞0．05），研究组舒张期基底段、中间段正向流量、正向总流量和总流量显著低于对照组（ P ＜0．05）。结论 VFM技术能够在任意断层成像，多方位的评价了心动周期任意阶段心脏各节段血流变化情况，对心肌梗死患者心脏内血流结构情况有较全面的了解。