Vonk Noordegraaf A, Kunst P W, Janse A, Marcus J T, Postmus P E, Faes T J, de Vries P M
Department of Pulmonary Medicine, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Physiol Meas. 1998 May;19(2):263-73. doi: 10.1088/0967-3334/19/2/013.
Electrical impedance tomography (EIT) is a recent imaging technique based on electrical impedance, offering the possibility of measuring pulmonary perfusion. In the present study the influence of several pulmonary haemodynamical parameters on the EIT signal were investigated. First, the influence on the systolic wave of the EIT signal (delta Zsys) of stroke volume, large pulmonary artery distensibility (both assessed by means of MRI) and the extent of the pulmonary peripheral vascular bed in 11 emphysematous patients (reduced peripheral vascular bed) and 9 controls (normal peripheral vascular bed) was investigated. Second, the influence of hypoxic pulmonary vasoconstriction on delta Zsys was examined in 14 healthy subjects. Finally, the origin of the diastolic wave was examined in three patients with atrioventricular dissociation. Multiple regression analysis showed that delta Zsys was only dependent on the variable emphysema (p < 0.02), but not dependent on stroke volume (p < 0.3) or pulmonary artery distensibility (p > 0.9). The mean value of delta Zsys for emphysematous patients (131 +/- 32 arbitrary units (AU)) was significantly lower (p < 0.001) than in the control group (200 +/- 39). In the group of healthy subjects delta Zsys decreased significantly (p < 0.001) during hypoxia (193 +/- 38 AU) compared with rest measurements (260 +/- 62 AU). The absence of the diastolic wave in the cardiological patients suggests the influence of reverse venous blood flow on the EIT signal. It is concluded that volume changes in the small pulmonary vessels contribute significantly to the EIT signal. Moreover, the hypoxia induced decrease in delta Zsys indicates the potential of EIT for measuring pulmonary vascular responses to external stimuli.
电阻抗断层成像(EIT)是一种基于电阻抗的新型成像技术,为测量肺灌注提供了可能。在本研究中,研究了几种肺血流动力学参数对EIT信号的影响。首先,研究了11例肺气肿患者(外周血管床减少)和9例对照组(外周血管床正常)的每搏输出量、大肺动脉扩张性(均通过MRI评估)以及肺外周血管床范围对EIT信号收缩波(δZsys)的影响。其次,在14名健康受试者中研究了缺氧性肺血管收缩对δZsys的影响。最后,在3例房室分离患者中研究了舒张波的起源。多元回归分析表明,δZsys仅取决于肺气肿变量(p<0.02),而不取决于每搏输出量(p<0.3)或肺动脉扩张性(p>0.9)。肺气肿患者的δZsys平均值(131±32任意单位(AU))显著低于对照组(200±39,p<0.001)。在健康受试者组中,与静息测量值(260±62 AU)相比,缺氧期间δZsys显著降低(p<0.001)(193±38 AU)。心脏病患者中舒张波的缺失提示逆向静脉血流对EIT信号的影响。得出的结论是,肺小血管中的容积变化对EIT信号有显著贡献。此外,缺氧引起的δZsys降低表明EIT具有测量肺血管对外界刺激反应的潜力。