The development of real-time two-dimensional Doppler echocardiography and its clinical significance in acquired valvular diseases. With special reference to the evaluation of valvular regurgitation.
The development of real-time two-dimensional Doppler echocardiography and its clinical significance in acquired valvular diseases. With special reference to the evaluation of valvular regurgitation.
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实时二维多普勒超声心动图的发展及其在获得性瓣膜疾病中的临床意义。
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发表时间：
1984
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通讯作者：
Akira Koyano
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作者：
Ryozo Omoto;Y. Yokote;Shinichi Takamoto;Shunei Kyo;Keisuke Ueda;H. Asano;K. Namekawa;C. Kasai;Yuji Kondo;Akira Koyano
在心脏病学和心血管外科领域，长期以来一直需要一种使用超声进行实时血流成像的非侵入性方法。最近，我们开发了一种用于临床的二维多普勒超声心动图(以下简称二维多普勒)方法，使我们能够实时无创地获得心内血流图像。本文的主要目的是描述新开发的血流成像系统“二维多普勒”，并展示其在获得性瓣膜疾病中的临床应用价值，特别是在评价瓣膜返流方面。原则上，该设备结合了传统的脉冲多普勒系统和新开发的自动相关器，在传统的二维超声心动图的同时，实时非侵入性地显示心脏跳动中给定横截面内的血流图像。该系统可以提供血流的方向、速度和湍流三种信息。对72例经血管造影和/或手术证实的获得性瓣膜病患者进行了二维超声心动图检查。在定量评估瓣膜返流方面，将二维多普勒与血管造影术(主动脉和二尖瓣病变)或手术结果(三尖瓣病变)进行比较。二尖瓣、二尖瓣和三尖瓣反流已被二维多普勒定量显示，且每一值的反流严重程度与血管造影或手术结果高度相关。综上所述，我们发现：(1)二维多普勒在检测和估计瓣膜返流的严重程度方面是非常有用的；(2)在某些情况下，二维多普勒可以替代常规的血管造影。
A noninvasive method for real time blood-flow imaging using ultrasound has long been required in the fields of cardiology and cardiovascular surgery. Recently, we developed a method of two-dimensional Doppler echocardiography (hereafter abbreviated as "2-D Doppler") for clinical use which allows us to obtain noninvasively, intracardiac blood-flow images in real time. The main purpose of this paper is to describe the newly developed blood-flow imaging system "2-D Doppler" and to demonstrate its clinical usefulness in acquired valvular diseases, particularly in the evaluation of valvular regurgitation. The device, in principle, combines a conventional pulsed-Doppler system and a newly developed auto-correlator, in which blood-flow images within a given cross section of a beating heart are noninvasively displayed in real time, simultaneously with conventional two-dimensional echocardiograms. The system can provide three kinds of information, direction, velocity and turbulence of blood flow. The 2-D Doppler examinations were carried out on 72 patients with acquired valvular diseases whose diagnoses were confirmed by angiography and/or surgery. Studies were performed comparing the findings of the 2-D Doppler and those of angiography (for aortic and mitral lesions) or with operative findings (for tricuspid lesions) in the quantitative evaluation of valvular regurgitation. Aortic, mitral and tricuspid valvular regurgitation have been quantitatively demonstrated with 2-D Doppler, and, for each value, the severity of the regurgitation showed a high correlation between the findings of 2-D Doppler and of angiography or surgery. In conclusion, we have found that (1) 2-D Doppler is very useful in detecting and estimating the severity of valvular regurgitation, and that (2) 2-D Doppler may replace conventional angiography in some situations.