Quantitative assessment of peripheral arterial obstruction in Raynaud's phenomenon: Development of a predictive model of obstructive arterial cross-sectional area and validation with a Doppler blood flow study
Quantitative assessment of peripheral arterial obstruction in Raynaud's phenomenon: Development of a predictive model of obstructive arterial cross-sectional area and validation with a Doppler blood flow study
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DOI：
10.1177/000331970005101202
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发表时间：
2000-12-01
期刊：
影响因子：
2.8
通讯作者：
McIlroy, MB
中科院分区：
文献类型：
--
作者：
Seitz, WS;Kline, HJ;McIlroy, MB
本研究的目的是开发一种能够提供诊断标准的雷诺现象条件下动脉阻塞的分析性评估方法。许多人试图通过多普勒超声测量动脉血流速度来确定和量化动脉阻塞。这些方法缺乏一种公式，允许根据直接测量得出的阻塞面积来评估动脉阻塞。作者使用脉冲、距离选通多普勒超声仪的速度信号频谱分析，对正常人和雷诺现象患者的手部动脉血流速度进行了定量测量。他们测量了心脏周期的峰值和平均速度，以及整个心脏周期的速度信号的时间积分。这些由温度变化引起的两种不同血流动力学状态的测量允许他们通过应用数字动脉循环的水力模型来计算由于温度变化而产生的动脉横截面积的变化分数。他们发现了一个表示阻塞面积分数的公式：DA/A=2(Dd-tau dv-vtau)/(D+vdtau)，其中D是速度信号的时间积分；tau是血流间期，v是血流速度；DD、dtau和dv是两种不同温度状态下两种不同血流动力学状态下D、tau和v的差值。他们的发现表明，在35摄氏度-25摄氏度的温度范围内，正常受试者的横截面面积减少了0.05摄氏度，而雷诺受试者的横截面面积减少了5.8%。基于13名受试者的研究结果，多普勒超声可以区分雷诺现象患者和正常受试者。此外，水力模型似乎为评估其他动脉阻塞性疾病的相对狭窄区域提供了可能性。
The objective of this study was to develop a method for the analytical assessment of arterial obstruction in conditions of Raynaud's phenomenon capable of providing diagnostic criteria. Numerous attempts have been made to determine and quantify arterial obstruction in terms of Doppler ultrasound measurements of arterial blood velocity. Absent from these methods is a formulation that allows an assessment of arterial obstruction based on the obstructed area as derived from direct measurement. The authors used spectral analysis of velocity signals from a pulsed, range-gated Doppler ultrasonic instrument to make quantitative measurements of arterial blood flow velocity in hands of normal subjects and persons with Raynaud's phenomenon. They measured the peak and mean velocity during the cardiac cycle and the time integral of the velocity signal over the cardiac cycle. These measurements for two distinct hemodynamic states induced by temperature changes allowed them to calculate the fractional change in arterial cross-sectional area produced by the change in temperature through the application of a hydraulic model of digital arterial circulation. They found an equation expressing fractional obstructed area expressed as: dA/A = 2 (dD - tau dv - v tau)/(D + vd tau), where D is the time integral of the velocity signal; tau is the blood flow interval, v is the blood velocity; and dD, d tau and dv are the differences in D, tau, and v at two different hemodynamic states produced by two different temperature states. Their findings suggest that over a temperature range of 35 degrees -25 degreesC, normal subjects experience 0.05/degreesC reduction in cross-sectional area while Raynaud subjects experience a reduction of 5.8%/degreesC.The results, based on findings in 13 subjects, suggest that Doppler ultrasound can differentiate persons with Raynaud's phenomenon from normal subjects. Additionally, the hydraulic model appears to offer the potential of assessing relative stenotic area in other arterial obstructive diseases.