Sung Chang Kyu, Lee Kyoung Ho, Kim Seung Hyup
Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Ultrasonography. 2017 Jan;36(1):39-52. doi: 10.14366/usg.15055. Epub 2016 Jul 7.
The aim of this study was to investigate factors that influence arterial Doppler waveforms in an phantom to provide a more accurate and comprehensive explanation of the Doppler signal.
A flow model was created using a pulsatile artificial heart, rubber or polyethylene tubes, a water tank, and a glass tube. Spectral Doppler tracings were obtained in multiple combinations of compliance, resistance, and pulse rate. Peak systolic velocity, minimum diastolic velocity, resistive index (RI), pulsatility index, early systolic acceleration time, and acceleration index were measured. On the basis of these measurements, the influences of the variables on the Doppler waveforms were analyzed.
With increasing distal resistance, the RI increased in a relatively linear relationship. With increasing proximal resistance, the RI decreased. The pulsus tardus and parvus phenomenon was observed with a small acceleration index in the model with a higher grade of stenosis. An increase in the distal resistance masked the pulsus tardus and parvus phenomenon by increasing the acceleration index. Although this phenomenon occurred independently of compliance, changes in the compliance of proximal or distal tubes caused significant changes in the Doppler waveform. There was a reverse relationship between the RI and the pulse rate.
Resistance and compliance can alter the Doppler waveforms independently. The pulse rate is an extrinsic factor that also influences the RI. The compliance and distal resistance, as well as proximal resistance, influence the pulsus tardus and parvus phenomenon.
本研究旨在探究影响模拟人体模型中动脉多普勒波形的因素,以便对多普勒信号作出更准确、全面的解释。
使用搏动性人工心脏、橡胶或聚乙烯管、水箱和玻璃管建立血流模型。通过顺应性、阻力和脉搏率的多种组合获取频谱多普勒描记图。测量收缩期峰值速度、舒张期末最低速度、阻力指数(RI)、搏动指数、收缩早期加速时间和加速指数。基于这些测量结果,分析各变量对多普勒波形的影响。
随着远端阻力增加,阻力指数呈相对线性增加。随着近端阻力增加,阻力指数降低。在狭窄程度较高的模型中,加速指数较小时观察到迟脉和小脉现象。远端阻力增加通过提高加速指数掩盖了迟脉和小脉现象。尽管此现象独立于顺应性发生,但近端或远端管道顺应性的变化会导致多普勒波形发生显著变化。阻力指数与脉搏率呈反向关系。
阻力和顺应性可独立改变多普勒波形。脉搏率是影响阻力指数的一个外部因素。顺应性、远端阻力以及近端阻力会影响迟脉和小脉现象。