Development of Intravascular and Intracardiac Ultrasound System Combined with Color Doppler Flow Imaging and Its Clinical Application in Cardiovascular Surgery

血管内超声（IVUS）在检测管腔内血栓、血管夹层或估计血流动力学方面的有效性有限。如果一种新的血管内超声系统能够同时提供有关血管中流速和流量的数据，则可以克服其中的一些限制。本研究的主要目的是开发一种新的血管内超声系统与彩色多普勒血流成像系统相结合，其次是评估新开发的“血管内超声系统”的可行性，以可视化血流和定量流速和体积，最后是研究在心血管外科临床应用的可能性。体外实验采用循环流动模型。通过改变离心泵的转速，产生不同速度（0- 150厘米/秒）的静态流。传感器被放置在流管的中心。新的IVUS系统由市售的彩色多普勒超声设备组成， ...更多信息 它是一个8 F IVUS导管，其中10 MHz机械旋转换能器倾斜（45度）安装在导管头端。它以5到10周/秒的速度旋转。二维血流图像显示方式与常规彩色多普勒技术相同。在流速大于2cm/sec的血流中获得了彩色多普勒图像。在速度指示混叠时，色调发生变化。彩色多普勒与脉冲多普勒（r=0.9998，p0.01<less than or equal>）、电磁流量计（r=0.943，<less than or equal>p0.01）测量的平均血流速度相关性显著。在体外实验中证实了新的彩色多普勒导管的安全性和有效性后，我们在三只猪和两名夹层动脉瘤患者中研究了新系统的性能。结果表明，临床上的可行性，特别是在主动脉疾病。结论：这种将血管内超声与彩色多普勒技术相结合的新系统在检测血管腔内异常血流、定量血流速度和体积以及估计血流动力学方面具有潜在的应用价值，并将提高常规血管内超声在心血管外科应用中的诊断能力。

The efficacy of intravascular ultrasound(IVUS) in the detection of intraluminal thrombi, vessel dissection, or for the estimation of blood flow dynamics is limited. Some of these limitations could be overcome if a new IVUS system could simultaneously provide data about flow velocity and flow volume in the vessels. The main purposes of this research were firstly to develop a new Intravascular Ultrasound System combined with Color Doppler Flow Imaging Systems, secondly to evaluate the feasibility of newly developed "IVUS system" for visualizing blood flow and quantifying flow velocity and volume, and finally to study the possibility of clinical use in Cardiovascular Surgery. In vitro experiments were performed using circulation flow model. The static flows with various velocity (0-l50cm/sec) were produced by altering rotation rate of a centrifugal pump. The transducer was placed at center of a flow tube. The new IVUS system consists of a commercially available color Doppler ultrasound un … More it, a 8F IVUS catheter which a 10MHz mechanically rotated transducer was mounted obliquely (45 degree) on the tip of catheter. It rotates at a rate of 5 to 10 cycles/sec. Two-dimensional flow images were displayed in the same way as conventional color Doppler techniques. The color Doppler images have been obtained in flows with velocity over 2 cm/sec. The color tone turned at velocity indication aliasing. The mean velocities obtained by color Doppler significantly correlate with those measured by pulsed wave Doppler (r=0.9998, p<less than or equal>0.O1) and electromagnetic flow meter (r=0.943, p<less than or equal>0.01) respectively. After the confirmation of safety and effectiveness of the new color Doppler catheter in in-vitro experiment, we studied the capability of the new system in three pigs and two patients with dissecting aneurysm. The results demonstrated the clinical feasibility especially in aortic diseases. It is our conclusion that this new system which combined IVUS with color Doppler technique is potentially useful for detection of abnormal blood flow in the vessel lumen, quantification of flow velocity and volume and estimation of flow dymanics, and should advance diagnostic capability of conventional IVUS in application of cardiovascular surg Less