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先進工程學刊

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篇名 模擬左心室四維動態運動並建構評估左心室心肌運動功能之分析工具
卷期 6:3
並列篇名 Assessing Motion Simulation of Left Ventricle and Myocardial Function
作者 陳文瑩馬銘徽胡威志
頁次 201-208
關鍵字 局部射血分率半徑變化率區域成長regional ejection fractionthe rate of radius of changeseed region grow
出刊日期 201107

中文摘要

心血管疾病的病患通常會伴隨著心臟運動異常的病徵,本研究首先建立左心室的立體模型並且校正中心軸,其中心軸為二尖瓣到心尖的連線,經手動校正後做重新取樣獲得以左心室長軸為中心的左心室短軸影像,然而為了精確計算每一塊心肌的運動,利用旋轉公式調整心肌位置,並且計算左心室長軸變化與半徑變化率這兩項模擬參數。在模擬方面本研究將左心室運動分解成兩種動作,其一為長軸變化的運動,其二為半徑變化率與阿基米德螺旋的扭轉運動。將左心室心肌分割18 區塊以動態影像與牛眼圖顯示運動變化計算局部射血分率與心肌位移變化以分析左心室局部心肌功能。實驗部分以十三位受測者的實際與模擬的左心室功能作分析,數據分析分為兩方面,其一為整體性左心室功能分析,利用左心室容積曲線與左心室容積變化率曲線證明實際與模擬左心室的整體運動狀況的相似度,而左心室容積 (r=0.99) 與左心室容積變化率 (r=0.97) 的結果顯示出很高的相關度。其二維局部心肌運動分析,根據實際與模擬的局部射血分率與心肌位移變
化做相關性與差異度分析,結果顯示其差異度在±2SD 之內,而心肌位移變化相關性為(r=0.87) 呈現出很好的相似度,藉由實驗結果說明本研究就建構的模擬工具對於模擬左心室運動的可行性。

英文摘要

Patients with cardiovascular disease such as cardiomyopathy and myocardial
infarction were usually having abnormal myocardial motion. For data pre-processing in this study, firstly, the reposition of the left ventricle in short axis view, the central axis of the 3D LV model was adjusted manually to be aligned with axis that was constructed using central point of short axis LV image from mitral valve to the apex of left ventricle.
And, then, the short axis LV images were obtained by re-sampling. To illustrate the regional myocardial motion, the data was portraying with the common accepted 18 myocardial regions on a Bull eyes graphical figure with the lively video display. A high resolution of 900 segments illustration was also provided. The result showed that correlation between simulated and controlled volume-time curve (VTC) was highly correlated. The VTC was 0.99 (r=0.99) and rate of volume change (RVC) was 0.97 (r=0.97). This demonstrated that the high correlation of global LV motion between the controlled data and 3D LV motion model. For the regional LV motion, the correlation between simulated model and controlled motion data of 18 myocardial regions on a completed cardiac cycle was 0.87 (r=0.87). The Bland-Altman analyses on the regional myocardial motion and regional ejection fraction were both within ±2STD. This demonstrated that the simulated model and the controlled data at every LV myocardial motion of whole cardiac cycle were similar. These results showed that a designated set of contraction functions was able to simulate the LV contraction that will be producing desired cardio output.

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