Evaluation of coronary bypass flow with color-Doppler and magnetic resonance imaging techniques: comparison with intraoperative flow measurements.
Evaluation of coronary bypass flow with color-Doppler and magnetic resonance imaging techniques: comparison with intraoperative flow measurements.
复制标题
用彩色多普勒和磁共振成像技术评估冠状动脉旁路流量：与术中流量测量的比较。
DOI：
10.1016/s1010-7940(99)00103-7
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
T. Carrel
中科院分区：
文献类型：
--
作者：
B. Walpoth;Markus F. Müller;I. Genyk;B. Aeschbacher;B. Kipfer;U. Althaus;T. Carrel
目的冠状动脉搭桥术后，通畅性和血流的评估是基于有创方法，如血管造影术和血管内超声或流线技术。本研究的目的是将冠脉搭桥术中通过时间的血流测量与术后早期彩色多普勒和磁共振成像评估进行比较。方法22例择期冠状动脉搭桥术患者(62岁，8.5岁)，采用传递时间血流技术测量所有内乳动脉(IMA)和隐静脉的血流。术后(第5±7天)所有患者均行彩色多普勒IMA血管评估，然后行MR血管成像和血流测量(应用和不应用造影剂的导航仪回波相位对比技术)以确定血管的通畅性和血流。结果数据以平均值(SD)表示。(1)所有患者均可识别左IMA至左冠状动脉前降支(LAD)的移植物，彩色多普勒和MRI均可评估其血流。静脉移植物只能在MRI上显示。(2)应用彩色多普勒技术，术中IMA-LAD平均血流速度为3317ml/min，术后平均IMA/LAD血流速度为6654ml/min，(3)术中、术后MR血流测量的收缩/舒张期血流比值分别为0.44±0.12，0.43±0.17，两者有显著相关性(r=0.57；P，0.04)，而与彩色多普勒血流的相关性较差。术后MR和彩色多普勒超声心动图与彩色多普勒超声心动图显示的收缩/舒张期血流比值具有良好的相关性(r0.88；P<0.008)。结论彩色多普勒超声心动图和磁共振成像是评价术后IMA血管通畅性的有效无创性方法。无论使用哪种技术，IMA血流的定量仍然很困难，但MR血流测量与术中测量的通过时间血流相关性最好。磁共振技术是冠状动脉搭桥术后最有前途的非侵入性评估方法，因为它允许可视化和可靠的血流定量。Q 1999爱思唯尔科学BV保留所有权利。
ObjectivesAfter coronary artery bypass surgery, patency and flow assessment is based on invasive methods such as angiography and intravascular ultrasound or flow wire techniques. The aim of the study was to compare intraoperative transit time flow measurements of coronary bypass grafts with early postoperative color-Doppler and MR-imaging assessment.MethodsIn 22 patients (62^ 8.5 years) undergoing elective coronary bypass surgery the flow was measured in all internal mammary artery grafts (IMA) and saphenous vein grafts using the transit time flow technique. Postoperatively (days 5±7) all patients had a color-Doppler IMA graft assessment followed by a MR-angiography and flow measurement (navigator echo phase contrast technique with and without contrast bolus application) to determine patency and graft flow.ResultsData are expressed as the mean^ SD).(1) In all patients the left IMA graft to the left anterior descending coronary artery (LAD) could be identified and flow could be assessed with both color-Doppler and MRI. Venous grafts could only be visualized by MRI. The use of an intravenous contrast bolus enhanced the visualization of coronary artery bypass grafts.(2) The mean IMA to LAD flow was 33^ 17 ml/min intraoperatively by transit time and postoperatively 36^ 25 ml/min by MR respectively 66^ 54 ml/min by color-Doppler technique.(3) The systolic/diastolic flow ratio was 0.44^ 0.12 intraoperatively and 0.43^ 0.17 postoperatively by MR respectively 0.67^ 1.0 by color-Doppler.(4) A statistically significant correlation could be demonstrated between intraoperative transit time and postoperative MR flow measurements (r 0.57; P, 0.04), whereas the correlations to color-Doppler flow were poor. Postoperatively MR and color-Doppler showed a good correlation of systolic/diastolic flow ratio (r 0.88; P, 0.008).ConclusionsThe color-Doppler method during echocardiography and MR-imaging are useful non-invasive techniques to visualize postoperative IMA grafts for patency assessment. The quantification of IMA flow is still difficult with either technique, but MR flow measurements showed the best correlation to the intraoperatively measured transit time flow. The MR technique is the most promising non-invasive method for postoperative evaluation of coronary bypass grafts, since it allows visualization and reliable flow quantification. q 1999 Elsevier Science BV All rights reserved.