Quantification of vortex flow in pulmonary arteries of patients with chronic thromboembolic pulmonary hypertension
Quantification of vortex flow in pulmonary arteries of patients with chronic thromboembolic pulmonary hypertension
复制标题
DOI：
10.1016/j.ejrad.2021.110142
复制
发表时间：
2022-01-20
影响因子：
3.3
通讯作者：
Takase, Kei
中科院分区：
文献类型：
--
作者：
Kamada, Hiroki;Ota, Hideki;Takase, Kei
目的：比较慢性血栓栓塞性肺动脉高压(CTEPH)患者球囊肺血管成形术(BPA)前后肺内涡流的存在时间。方法：对28例慢性血栓栓塞性肺动脉高压(CTEPH)患者球囊肺动脉成形术(BPA)前后行胸部4D-Flow磁共振成像。在肺动脉中设置平面以评估容量流率(VFR)、肺动脉干的回流时间和面积，这是涡流的一个组成部分。结果：尽管BPA后的整体血流模式与BPA前相同，但BPA后的FWHM、面积和VFR均显著降低(FWHM：BPA前1.88×10(-1)+/-1.51×10(-2)[心动周期]vs.1.65×10(-1)+/-1.86×10(-2)[心动周期]；面积比：前为2.67×10(-1)+/-1.30×10(-2)比后为2.38×10(-1)+/-1.31×10(-2)；VFR：前为13.6+/-2.21[毫升/S]，后为11.3+/-2.36[毫升/S]。对于双酚A更显著降低压力的情况，这些变化的趋势更大。结果提示，半高宽、面积和VFR是无创性评价BPA疗效的有用指标。
Purpose: This study proposes an objective method of quantifying the vortex flow in pulmonary arteries to compare the duration of its presence before and after balloon pulmonary angioplasty (BPA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods: Thoracic 4D-flow magnetic resonance imaging was performed in 28 CTEPH patients before and after BPA. Planes were set in pulmonary arteries to evaluate volume flow rate (VFR), the duration, and area of backward flow in the pulmonary trunk, which is a component of the vortex flow. The full width at half maximum (FWHM) of the peak of the time course of VFR of backward flow was assessed to quantify the duration of the vortical flow.Results: Although overall flow patterns after BPA appeared to be the same as the one before BPA, significant decreases in the FWHM, area, and VFR of the backward flow after BPA were found (FWHM: before, 1.88 x 10(-1) +/- 1.51 x 10(-2) [cardiac cycle] vs. after, 1.65 x 10(-1) +/- 1.86 x 10(-2) [cardiac cycle]; area ratio: before, 2.67 x 10(-1) +/- 1.30 x 10(-2) vs. after, 2.38 x 10(-1) +/- 1.31 x 10(-2); VFR: before, 13.6 +/- 2.21 [mL/s] vs. after, 11.3 +/- 2.36 [mL/s]).Conclusion: BPA promoted significant decreases in the FWHM, area, and VFR of backward flow in the pulmonary trunk, thereby facilitating efficient blood transport. The tendencies for these changes were to be larger for cases where BPA more greatly decreased the pressure. The results suggest that the FWHM, area, and VFR are useful indicators for the noninvasive evaluation of the therapeutic effects of BPA.