開發三維立體工具應用於多切面CT影像以分析左心室心臟功能

Development of 3D tool with Multidetector Row Computed Tomography for analysing LV function

薛若盈(Jo-ying Hsueh)

指導教授 ： 胡威志

中原大學/工學院/醫學工程研究所/碩士(2009年)

https://doi.org/10.6840/cycu200900338

摘要

冠狀動脈疾病及左心室功能不全的病患在左心室型態及運動狀態上會與健康者有很大的差異，分析形態與運動狀態的功能可藉由心動週期中容積及心室壁運動與心室壁厚度得知，本研究利用心臟電腦斷層影像分析左心室心臟功能參數，參數包含整體容積變化(volume-time curve, VTC)、射血分率(ejection fraction, EF)、最大排血率(peak ejection rate, PER)、最大率充血率(peak filling rate, PFR)、心室壁運動(wall motion, WM)及心室壁厚度(wall thickness, WT)、心室壁移動量(WM(ED-ES))、心室壁厚度移動量(WT(ED-ES))，而最大排血率到最大充血率之間容積變化的線性斜率(PER-RFR slope)可以表現出收縮與舒張之間的狀態。
本研究使用三維立體影像利用手動與自動的方式將左心室與主動脈和左心房分隔開來，在三維選取平面中利用平面校正的方式使分隔線更為準確。左心室的內膜邊緣搜尋是利用區域成長的方式，外膜邊緣搜尋是利用影像處理搭配自動與手動的方式，並運算一個心臟週期的容積變化與參數分析結果，討論左心室功能指標EF與本研究系統分析的參數做相關性的探討。
分析七個非心房顫動之心臟電腦斷層影像，其平均射血分率為73.12±4.44%，由射血分率表示之受測者心室狀況皆良好，本研究加入五位容積曲線良好，射血分率分佈較低的受測者共十二位Subjects做參數與EF之間相關性探討，結果顯示EF與心搏出量(stroke volume, SV)相關度為 ；EF與PER-PFR slope相關度為 ；EF與心室壁移動量相關度為 ；EF與心室壁厚度移動量相關度為 ，即EF與估算出的左心室功能參數如PER-PFR slope皆有良好的正相關度。

關鍵字

左心室 ； 區域成長 ； 射血分率 ； 心室壁運動 ； 心室壁厚度

並列摘要

The purpose of this study is to observe the significant differences on the shape and motion of the heart between health heart and heart with coronary artery disease or the dysfunction non-invasively. We will be using the parameters of the left ventricle reconstructed from cardio CT images to analyze ventricular functions. The parameters were volume-time curve (VTC), ejection fraction (EF), peak ejection rate (PER), peak filling rate (PFR), wall motion (WM), and wall thickness (WT).
To delineate and integrate LV contour, first, we have constructed the 3D cardiac model that was used for the separation of left ventricle from the aorta and mitral valve. Second, the seed region growth algorithm was used to delineate both endocardial and epicardial contour slice by slice.
This study has researched into the correlation between the above-mentioned parameter and the EF values. The subjects include seven patients with suspected AF, and the other five patients with mitral valve problem. The results showed that correlation between stroke volume and EF was 0.89 (r=0.89). The correlation between the rate change from PER to PFR and EF was 0.88(r=0.88). The correlation between quantity of wall motion and EF was 0.92 (r=0.92).The correlation between quantity of wall thickness and EF was 0.8 (r=0.8). According to the results, it is useful for evaluating the function of left ventricle.

並列關鍵字

left ventricle ； wall motion ； wall thickness ； ejection fraction

參考文獻

[17] 李佳融, "半自動式左心室三維動態模型之運動和形態分析系統,"醫學工程所. vol. 碩士學位: 中原大學, 2002.

[18] 陳巨弦, "實時四維超音波動態心臟影像顯示及分析系統,"醫學工程所. vol. 碩士學位: 中原大學, 2005.

[19] 吳明鴻, “利用心臟電腦斷層影像評估左心房與左心耳之射血功能,” 醫學工程所. vol. 碩士學位: 中原大學, 2007.

[1] G. Gilman, B. K. Khandheria, M. E.Hagen, T. P. Abraham, J. B. Seward, and M. Belohlavek, "Strain Rate and Strain: A Step-by-step Approach to Image and Data Acquisition," Journal of the American Society of Echocardiography, vol. 17, pp. 1011-1020, 2004.

[3] F. I. Parthenakis, V. K. Prassopoulos, S. I. Koukouraki, E. A. Zacharis, G. F. Diakakis, N. K. Karkavitsas, and P. E. Vardas, "Segmental pattern of myocardial sympathetic denervation in idiopathic dilated cardiomyopathy: Relationship to regional wall motion and myocardial perfusion abnormalities," Journal of Nuclear Cardiology, vol. 9, pp. 15-22, 2002.