CRCHUM-Research Centre, University of Montreal Hospital, Montreal, QC H2L2W5, Canada.
IEEE Trans Med Imaging. 2010 Oct;29(10):1701-13. doi: 10.1109/TMI.2010.2049656. Epub 2010 Jun 17.
Doppler echocardiography remains the most extended clinical modality for the evaluation of left ventricular (LV) function. Current Doppler ultrasound methods, however, are limited to the representation of a single flow velocity component. We thus developed a novel technique to construct 2D time-resolved (2D+t) LV velocity fields from conventional transthoracic clinical acquisitions. Combining color-Doppler velocities with LV wall positions, the cross-beam blood velocities were calculated using the continuity equation under a planar flow assumption. To validate the algorithm, 2D Doppler flow mapping and laser particle image velocimetry (PIV) measurements were carried out in an atrio-ventricular duplicator. Phase-contrast magnetic resonance (MR) acquisitions were used to measure in vivo the error due to the 2D flow assumption and to potential scan-plane misalignment. Finally, the applicability of the Doppler technique was tested in the clinical setting. In vitro experiments demonstrated that the new method yields an accurate quantitative description of the main vortex that forms during the cardiac cycle (mean error for vortex radius, position and circulation). MR image analysis evidenced that the error due to the planar flow assumption is close to 15% and does not preclude the characterization of major vortex properties neither in the normal nor in the dilated LV. These results are yet to be confirmed by a head-to-head clinical validation study. Clinical Doppler studies showed that the method is readily applicable and that a single large anterograde vortex develops in the healthy ventricle while supplementary retrograde swirling structures may appear in the diseased heart. The proposed echocardiographic method based on the continuity equation is fast, clinically-compliant and does not require complex training. This technique will potentially enable investigators to study of additional quantitative aspects of intraventricular flow dynamics in the clinical setting by high-throughput processing conventional color-Doppler images.
多普勒超声心动图仍然是评估左心室(LV)功能最广泛的临床方法。然而,目前的多普勒超声方法仅限于表示单一的流速分量。因此,我们开发了一种从常规经胸临床采集构建 2D 时变(2D+t)LV 速度场的新技术。该技术结合彩色多普勒速度和 LV 壁位置,在平面流假设下使用连续性方程计算跨束血流速度。为了验证算法,在房室复制器中进行了 2D 多普勒流量映射和激光粒子图像 velocimetry(PIV)测量。相位对比磁共振(MR)采集用于测量体内由于 2D 流假设和潜在扫描平面失准引起的误差。最后,在临床环境中测试了多普勒技术的适用性。体外实验表明,该新方法可准确定量描述心动周期中形成的主涡(涡半径、位置和循环的平均误差)。MR 图像分析表明,平面流假设引起的误差接近 15%,并且不会排除在正常或扩张的 LV 中对主要涡特性的特征化。这些结果有待通过头对头的临床验证研究来证实。临床多普勒研究表明,该方法易于应用,并且健康心室中会形成单个大的向前涡,而在患病心脏中可能会出现补充的逆行旋转结构。基于连续性方程的超声心动图方法快速、符合临床要求,并且不需要复杂的培训。这项技术将有可能使研究人员能够通过高通量处理常规彩色多普勒图像来研究临床环境中心室内流动动力学的其他定量方面。