Assessment of Blood Flow Transport in the Left Ventricle Using Ultrasound. Validation Against 4-D Flow Cardiac Magnetic Resonance.
Assessment of Blood Flow Transport in the Left Ventricle Using Ultrasound. Validation Against 4-D Flow Cardiac Magnetic Resonance.
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DOI：
10.1016/j.ultrasmedbio.2022.05.007
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发表时间：
2022-09
影响因子：
2.9
通讯作者：
Bermejo, J. A. V. I. E. R.
中科院分区：
文献类型：
--
作者：
Postigo, A. N. D. R. E. A.;Viola, F. E. D. E. R. I. C. A.;Chazo, C. H. R. I. S. T. I. A. N.;Martinez-legazpi, P. A. B. L. O.;Gonzalez-mansilla, A. N. A.;Rodriguez-gonzalez, E. L. E. N. A.;Fernandez-aviles, F. R. A. N. C. I. S. C. O.;Alamo, Juan c del;Ebbers, T. I. N. O.;Bermejo, J. A. V. I. E. R.
关键词：
四维血流心脏磁共振(CMR)是分析左心室(LV)血液传输的参考技术，但从超声可以获得类似的信息。我们的目标是在与4D Flow CMR的头对头比较中验证超声衍生的传输。在5例患者和2例健康志愿者中，我们分别用经胸超声心动图和CMR获得了左室内的2D+t和3D+t(4D)流场。我们将脑室内血流量划分为四个部分：直接流量(DF)、留存流入流量(RI)、延迟射血流量(DEF)和残余容量(RV)。我们还利用超声计算了LV充盈波的性质(E/A波携带的LV穿透百分率和LV容量百分率)，以确定它们与CMR传输的关系。两种定量转运分数的方法对于DF和RV的一致性较好(Ric[95%可信区间]分别为0.82[0.33，0.97]和0.85[0.41，0.97])，对于RI和DEF的一致性中等(Ric=0.47[−分别为0.29，0.88]和0.55[−分别为0.20，0.90])。测量动能的技术之间的一致性是可变的。E波载血量与Df和RV呈正相关(R=0.75和R=0.63)。因此，超声是一种适合于在临床环境下扩展脑室内血流传输分析的方法。
Four-dimensional flow cardiac magnetic resonance (CMR) is the reference technique for analyzing blood transport in the left ventricle (LV), but similar information can be obtained from ultrasound. We aimed to validate ultrasound-derived transport in a head-to-head comparison against 4D flow CMR. In five patients and two healthy volunteers, we obtained 2D + t and 3D + t (4D) flow fields in the LV using transthoracic echocardiography and CMR, respectively. We compartmentalized intraventricular blood flow into four fractions of end-diastolic volume: direct flow (DF), retained inflow (RI), delayed ejection flow (DEF) and residual volume (RV). Using ultrasound we also computed the properties of LV filling waves (percentage of LV penetration and percentage of LV volume carried by E/A waves) to determine their relationships with CMR transport. Agreement between both techniques for quantifying transport fractions was good for DF and RV (Ric [95% confidence interval]: 0.82 [0.33, 0.97] and 0.85 [0.41, 0.97], respectively) and moderate for RI and DEF (Ric= 0.47 [−0.29, 0.88] and 0.55 [−0.20, 0.90], respectively). Agreement between techniques to measure kinetic energy was variable. The amount of blood carried by the E-wave correlated with DF and RV (R = 0.75 and R = 0.63, respectively). Therefore, ultrasound is a suitable method for expanding the analysis of intraventricular flow transport in the clinical setting.
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