Dequeker J L, Jimenez M, Gosse P, Roudaut R, Pouydebat P, Gonçalves do Nascimento L, Emeriau J P, Choussat A
Hôpital cardiologique, centre hospitalier du Haut-Lévêque, Pessac.
Arch Mal Coeur Vaiss. 1988 Mar;81(3):311-6.
Pulsed Doppler-echocardiography was used to measure systemic and pulmonary blood flows in 22 patients aged from 3 months to 62 years presenting with interatrial (n = 13) or interventricular (n = 9) septal defect. Calculations were based on echographic measurements of aortic and pulmonary orifice areas and on the integral of maximal aortic and pulmonary Doppler velocity curves. Section areas or the arteries, taken as being circular, were deduced from arterial diameter measurements effected above Valsalva's sinus. Doppler velocity curves were recorded at that level, looking for maximal velocities and assuming a flat velocity profile. Blood flow ratios evaluated from Doppler-echocardiography data were compared with data provided by oximetry and showed good correlations (r = 0.92; Y = 0.71x + 0.53; SEE = 0.24). Calculations by categories of lesions showed better results in patients with interatrial septal defect (r = 0.94; Y = 0.73x + 0.507; SEE = 0.22) than in patients with interventricular septal defect (r = 0.83; Y = 0.547x + 0.75; SEE = 0.25). The main difficulties encountered in measuring Doppler-echocardiography blood flow ratios concerned accurate measurement of pulmonary artery diameter, due to problems of lateral resolution, and accurate measurement of turbulent Doppler velocimetry curves. However, this new, non-invasive technique may be useful to determine the best indications for catheterization or even surgery.
采用脉冲多普勒超声心动图测量了22例年龄从3个月至62岁、患有房间隔缺损（n = 13）或室间隔缺损（n = 9）患者的体循环和肺循环血流量。计算基于主动脉和肺动脉口面积的超声测量以及主动脉和肺动脉多普勒速度曲线的积分。动脉截面积假定为圆形，由在主动脉窦上方进行的动脉直径测量推导得出。在该水平记录多普勒速度曲线，寻找最大速度并假定速度分布为平坦状。将根据多普勒超声心动图数据评估的血流比率与血氧测定法提供的数据进行比较，结果显示具有良好的相关性（r = 0.92；Y = 0.71x + 0.53；标准误 = 0.24）。按病变类别进行的计算显示，房间隔缺损患者（r = 0.94；Y = 0.73x + 0.507；标准误 = 0.22）的结果比室间隔缺损患者（r = 0.83；Y = 0.547x + 0.75；标准误 = 0.25）更好。在测量多普勒超声心动图血流比率时遇到的主要困难涉及由于侧向分辨率问题导致的肺动脉直径的准确测量以及湍流多普勒测速曲线的准确测量。然而，这种新的非侵入性技术可能有助于确定导管插入术甚至手术的最佳适应症。
