4D左心室心肌運動變量模型之應用

Four-dimensional Wall Motion Model for Application of Left Ventricular Myocardial Function

曾華淵(Hua-Yuan Tseng)；簡士凱(Shih-Kai Chien)；胡威志(Wei-Chih Hu)

左心室重塑 ； 心肌運動 ； 纖維化組織 ； Left ventricular remodeling ； Myocardial wall motion ； Fibrotic tissue

先進工程學刊

15卷1期（2020 / 04 / 01）

41 - 51

繁體中文

心室重塑與整體心肌的受力分配不均有顯著關係，若能找出心肌運動不良的區域，對於心室重塑的預防與監測能提供另一種參考資訊。本研究利用電腦斷層影像建構四維心肌運動模擬工具，藉由計算左心室各區域心肌的運動變化量進行運動功能的評估，低運動量區域即為心肌受損處。透過探討低運動量區域與術後纖維化區域的相關性，本研究發現患者手術後部位，約有40%不會產生纖維化組織，但心肌損傷較嚴重時，即使無纖維化組織產生，仍然會表現出低運動量狀態；其餘60%則具有纖維化區域，此區必定會發生低運動量狀態，且低運動量區域位置與纖維化區域位置必定重疊。此外本研究也觀察到心肌運動量下降會導致低運動量區域的半徑變化率比健康區域低。結果表明本研究的模擬工具能夠有效評估心肌運動功能狀態與纖維化區域位置，對於評量左心室運動有可行性。

Regional dysfunction of myocardium will be leading to functional abnormality of cardiac wall motion that is one of the risk factors for ventricular remodeling and heart failure. This study sought to characterize global and regional systolic function abnormalities. The self-developed 4D image processing software will be extracting the wall motion of left ventricle from a 4D cardiac images. The region of wall motion less than 2mm that was lower than average will be labeled the scar position. Four data set of fibrotic scar delay enhanced cardiac images and 4D cardiac wall motion images was used to test this non-invasive method of early detection cardiac abnormality. The patient after surgery with fibrotic scar tissue necessarily has lower myocardial motion value. However, fibrotic scar tissue will not show up in 40% of patients after surgery but the operated area may still have lower myocardial motion. The detection wall motion could effectively reflect the dysfunction of myocardium. Thus, this study provides a new approach to assess the degree and site dysfunction area of myocardium.

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