磁振影像(Magnetic Resonance Imaging, MRI) 提供非侵入性的方式在臨床上應用。法洛氏四重症患者經過手術矯正後，肺動脈的血流仍然會有紊流與逆流的現象。本研究利用相位對比影像來做量化分析，並且觀察矯正後患者的血液流動情形。我們利用Coefficient of Variance(CV)、Regurgitant Fraction(RF)、Net Flow 等參數分析患者的左肺動脈、右肺動脈與主肺動脈的血流混亂程度與逆流的狀況，並且跟正常人做比較找出之間的差異。
肺循環是指右心室流向主肺動脈在流入左肺動脈與右肺動脈。我們再額外利用三個參數:rPA/lPA flow ratio、Peak Velocities 與Total Flow，來觀察肺動脈血流情況。利用rPA/lPA flow ratio 找出血液流動的傾向，用Peak Velocities 探討正常人與患者最大流速的差異，用Total Flow 來觀察主肺動脈流出到左、右肺動脈的血流量。希望利用這些參數可以幫助醫生做臨床上的診斷。

Magnetic Resonance Imaging (MRI) provides noninvasive method in clinical application. For the patients of Tetralogy of Fallot underwent surgical correction,regurgitation and turbulence in blood flow may still present in pulmonary arteries.In this study,Phase Contrast MR Imaging will be used to quantitate,and to observe blood flow in after repair Tetralogy of Fallot (TOF) patients.We use 3 parameters,which are Coefficient of Variance (CV),Regurgitant Fraction (RF) and Net Flow analysis to analyze two situations of blood flow in patients’ left pulmonary artery 、right pulmonary artery and main pulmonary artery.We also compare normal subjects to patients in this experiment.
The pulmonary circulation is the action of blood flow from right ventricular to main pulmonary artery then to left pulmonary artery and right pulmonary artery. We use three additional parameters: rPA / lPA flow ratio、Peak Velocities and Total Flow to observe the pulmonary blood flow. We use rPA / lPA flow ratio to identify the tendency of blood flow, with Peak Velocities to find out Peak Velocity in normal difference between patient.Meanwhile, the measurement of Total Flow is applied to observe the flow from main pulmonary artery to left and right pulmonary artery. We hope to use these parameters that can help doctors on clinical diagnosis.

致謝..................................................................................................... i
摘要..................................................................................................... ii
Abstract ............................................................................................... iii
目錄..................................................................................................... v
圖目錄.................................................................................................. vi
表目錄.................................................................................................. vii
1 第一章緒論..................................................................................... 1
1.1 背景....................................................................................... 1
1.1.1 磁振造影(Magnetic Resonance Imaging, MRI) ..... 1
1.1.2 Phase Contrast MRI............................................... 1
1.2 文獻回顧............................................................................... 2
1.2.1 Fontan 定量分析..................................................... 2
1.2.2 湧昇流分析............................................................. 3
1.2.3 四維流量分析......................................................... 3
1.3 法洛氏四重症(Tetralogy of Fallot, TOF)............................. 4
1.4 動機....................................................................................... 6
1.5 組織架構............................................................................... 6
2 第二章原理與方法.......................................................................... 10
2.1 PC MRI 原理........................................................................ 10
2.2 資料前處理............................................................................ 11
2.2.1 資料取得................................................................. 11
2.2.2 Region Of Interest, ROI ......................................... 11
2.2.3 投影........................................................................ 12
2.3 分析參數............................................................................... 12
2.3.1 Coefficient of Variantion, CV ................................. 12
2.3.2 Net Flow................................................................. 13
2.3.3 Regurgitant Fraction, RF ....................................... 13
2.3.4 Total Flow .............................................................. 13
2.3.5 rPA/lPA Flow ratio ................................................ 14
2.3.6 Peak Velocities........................................................ 14
3 第三章結果與討論.......................................................................... 20
3.1 資料來源............................................................................... 20
3.2 資料統計............................................................................... 21
3.3 結果....................................................................................... 21
3.3.1 Coefficient of Variation........................................... 22
3.3.2 Net Flow................................................................. 23
3.3.3 Regurgitant Fraction .............................................. 23
3.3.4 Peak Velocities........................................................ 24
3.3.5 Total Flow .............................................................. 24
3.3.6 rPA/lPA flow ratio ................................................. 25
3.4 討論....................................................................................... 26
4 第四章結論..................................................................................... 45
參考文獻.............................................................................................. 47

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