Bourguignon M H, Links J M, Douglass K H, Alderson P O, Roland J M, Wagner H N
Am J Cardiol. 1981 Dec;48(6):1086-90. doi: 10.1016/0002-9149(81)90324-6.
A new method for quantification of left to right cardiac shunts was studied in 17 patients scheduled for cardiac catheterization who had also undergone radionuclide angiocardiography. The observed pulmonary transit curve was deconvoluted in two different ways: (1) by the superior vena caval ("bolus") time-activity curve, to yield the deconvoluted pulmonary transit curve, which represented the theoretical pulmonary transit curve with a perfect bolus injection, and (2) by the right ventricular time-activity curve, to yield the pulmonary transfer function, which represented the theoretical pulmonary transit curve with a perfect bolus injection an with no intracardiac shunts. The pulmonary transfer function was superimposed on the deconvoluted pulmonary transit curve, and the area A under it obtained. The pulmonary transfer function was then subtracted from the deconvoluted pulmonary transit curve. The pulmonary transfer function was scaled to fit the resulting shunt recirculation peak in the difference curve, and the area B under this scaled pulmonary transfer function obtained. Shunt size was quantified as the pulmonary (QP) to systemic (QS) flow ration QP/QS = A/(A-B). The method correlated closely with oximetry (r = 0.93). Use of this multiple deconvolution analysis technique provides accurate shunt quantification and reduces subjective operator decisions.
对17例计划接受心导管检查且已进行放射性核素心血管造影的患者研究了一种定量左向右心脏分流的新方法。观察到的肺转运曲线通过两种不同方式进行反卷积：（1）通过上腔静脉（“团注”）时间-活性曲线，以产生反卷积的肺转运曲线，该曲线代表完美团注注射时的理论肺转运曲线；（2）通过右心室时间-活性曲线，以产生肺传递函数，该函数代表完美团注注射且无心脏内分流时的理论肺转运曲线。将肺传递函数叠加在反卷积的肺转运曲线上，并获得其下方的面积A。然后从反卷积的肺转运曲线中减去肺传递函数。将肺传递函数进行缩放以拟合差值曲线中产生的分流再循环峰值，并获得该缩放后的肺传递函数下方的面积B。分流大小定量为肺（QP）与体循环（QS）血流量之比QP/QS = A/（A - B）。该方法与血氧测定法密切相关（r = 0.93）。使用这种多重反卷积分析技术可提供准确的分流定量，并减少操作者的主观判断。
