發(fā)布時(shí)間：2018-06-22 08:00

  本文選題：分段式脈搏波成像 + 血管硬度�。� 參考：《深圳大學(xué)》2017年碩士論文

【摘要】：動(dòng)脈硬化一般起病隱匿,進(jìn)展緩慢,嚴(yán)重時(shí)會(huì)導(dǎo)致心血管疾病的發(fā)生如心臟病、中風(fēng)、腦血栓等,心血管疾病現(xiàn)已成為全世界人口死亡的主要原因,因此早期診斷動(dòng)脈彈性對(duì)預(yù)防與治療心血管疾病有著重要意義。動(dòng)脈脈搏波起始于左心室,作為壓力波在動(dòng)脈樹(shù)中傳播,同時(shí)引起管壁的收縮膨脹。臨床認(rèn)為脈搏波速度是反映動(dòng)脈彈性一個(gè)重要指標(biāo),是臨床評(píng)價(jià)動(dòng)脈彈性的金標(biāo)準(zhǔn)。血管在不同位置硬度是不同的,脈搏波速度也不一樣,因此需要測(cè)量局部血管的脈搏波速度,這樣才能更準(zhǔn)確的反映血管的力學(xué)特性,從而為臨床診斷提供可靠的依據(jù)。本文的主要目的是利用局部血管處的脈搏波速度定量評(píng)估管壁甚至斑塊的硬度,為此需要尋找一種能夠無(wú)創(chuàng)、準(zhǔn)確測(cè)量局部脈搏波速度的技術(shù)�，F(xiàn)有的超聲脈搏波速度測(cè)量技術(shù),如血管回聲跟蹤技術(shù)的可重復(fù)性和準(zhǔn)確性都較差,而UltraFast極速脈搏波速度測(cè)量技術(shù)應(yīng)用范圍狹窄。脈搏波成像是目前測(cè)量脈搏波速度的新技術(shù),能夠捕捉到任意血管位置的脈搏波傳播,提供豐富的血管彈性信息,尚未進(jìn)入臨床應(yīng)用。本文重點(diǎn)探究了超聲脈搏波成像這一方法在定量評(píng)估血管硬度的臨床可行性。本文提出了一種新的成像方法—分段式脈搏波成像,對(duì)頸動(dòng)脈管壁、斑塊進(jìn)行硬度測(cè)量,1)首先利用有限元仿真軟件COMSOL仿真血管—管壁的流固耦合作用,捕捉管壁上的脈搏波,對(duì)脈搏波速度與血管硬度的關(guān)系進(jìn)行了研究,證實(shí)了利用脈搏波速度可以定量評(píng)估血管硬度;2)對(duì)分段式脈搏波成像中的散斑追蹤算法進(jìn)行了研究,選出了一種相對(duì)優(yōu)秀的血管壁位移追蹤的算法;利用生物力學(xué)測(cè)試儀對(duì)血管仿體的硬度進(jìn)行測(cè)量,作為金標(biāo)準(zhǔn),驗(yàn)證了超聲脈搏波成像所得的血管管壁硬度的準(zhǔn)確性;通過(guò)不同的數(shù)據(jù)處理方式,評(píng)估了血管硬度測(cè)量時(shí)所需的超聲系統(tǒng)成像參數(shù);3)目前的超聲脈搏波成像技術(shù)最主要的做法是通過(guò)減少線(xiàn)密度提高幀率,線(xiàn)密度是影響分段式脈搏波成像的一個(gè)關(guān)鍵因素,針對(duì)此缺陷提出將平面波成像技術(shù)應(yīng)用于分段式脈搏波成像,通過(guò)血管仿體實(shí)驗(yàn)證實(shí)了可行性;4)與深圳市第二人民醫(yī)院超聲科合作,采集了正常人頸動(dòng)脈與動(dòng)脈粥樣硬化患者相關(guān)的臨床實(shí)驗(yàn)數(shù)據(jù),利用分段式脈搏波成像對(duì)其硬度進(jìn)行了計(jì)算;對(duì)比正常人頸動(dòng)脈與動(dòng)脈粥樣硬化患者結(jié)果,不僅能夠明顯的區(qū)分管壁、斑塊的軟硬程度,還能區(qū)分斑塊、管壁的交界位置,與傳統(tǒng)血管超聲彈性方法相比,靈敏度更高。
[Abstract]:Arteriosclerosis, which usually starts and progresses slowly, can lead to cardiovascular diseases such as heart disease, stroke, cerebral thrombosis and so on. Cardiovascular disease has become the leading cause of death in the world's population. Therefore, early diagnosis of arterial elasticity is of great significance in the prevention and treatment of cardiovascular diseases. The arterial pulse wave originates from the left ventricle and propagates through the arterial tree as a pressure wave, which also causes the contraction and expansion of the wall. Pulse wave velocity is considered as an important index to reflect arterial elasticity and a gold standard for clinical evaluation of arterial elasticity. The hardness of blood vessels is different in different positions and the pulse wave velocities are different. So it is necessary to measure the pulse wave velocities of local blood vessels so as to more accurately reflect the mechanical characteristics of blood vessels and provide reliable basis for clinical diagnosis. The main purpose of this paper is to quantitatively evaluate the hardness of the wall and even plaque by using the pulse wave velocity of the local blood vessel. Therefore, we need to find a non-invasive and accurate technique to measure the local pulse wave velocity. The existing ultrasonic pulse wave velocity measurement techniques, such as vascular echo tracking, have poor repeatability and accuracy, while UltraFast pulse velocity measurement technology has a narrow range of application. Pulse wave imaging is a new technique to measure pulse wave velocity at present. It can capture pulse wave propagation at any position of blood vessel and provide abundant information of vessel elasticity. It has not been applied in clinic. This paper focuses on the clinical feasibility of ultrasonic pulse wave imaging in quantitative evaluation of vascular hardness. In this paper, a new imaging method, segmental pulse wave imaging, is proposed. The hardness of carotid artery wall and plaque is measured. Firstly, the fluid-solid coupling between vessel and wall is simulated by finite element simulation software COMSOL to capture the pulse wave on the wall. The relationship between pulse wave velocity and blood vessel hardness is studied. It is proved that pulse wave velocity can be used to quantitatively evaluate the vascular hardness. (2) the speckle tracing algorithm in segmented pulse wave imaging is studied. A relatively excellent algorithm for tracking the displacement of vascular wall is selected, and the hardness of vascular imitating body is measured by biomechanical testing instrument, which is used as gold standard to verify the accuracy of the hardness of vascular wall obtained by ultrasonic pulse wave imaging. By using different data processing methods, the ultrasonic system imaging parameters needed for vascular hardness measurement are evaluated. (3) the most important method of ultrasonic pulse wave imaging is to increase the frame rate by reducing the linear density. Linear density is a key factor affecting segmented pulse wave imaging. In view of this defect, plane wave imaging technology is applied to segmented pulse wave imaging. The feasibility of the experiment was confirmed by blood vessel phantom test. (4) the clinical data of carotid artery and atherosclerosis patients in normal people were collected in cooperation with ultrasound department of Shenzhen second people's Hospital. The hardness was calculated by segmental pulse wave imaging. Comparing the results of carotid artery and atherosclerotic patients in normal people, not only the wall, the soft and hard degree of plaque, but also the junction of plaque and wall could be distinguished. Compared with the traditional vascular ultrasound elastic method, the sensitivity is higher.
【學(xué)位授予單位】：深圳大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R543;TP391.41

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