肺心病患者左右心功能的MRI研究  

Assessment of the Right and Left Ventricular Function in Patients with Cor Pulmonale Using MRI

作　　者：高艳[1] 李坤成[1] 秦俭[2] 杜祥颖[1] 尹建国[1] 杨旗[1] 

机构地区：[1]首都医科大学宣武医院放射科,北京100053 [2]首都医科大学宣武医院急诊科,北京100053

出　　处：《临床放射学杂志》2012年第2期192-195,共4页Journal of Clinical Radiology

摘　　要：目的探讨MRI评价肺心病患者左、右心功能的应用价值。资料与方法前瞻性研究18例经肺功能实验、临床检查、X线、心电图、超声心动图等影像学检查证实为合并慢性阻塞性肺病(COPD)的肺心病患者,另选取18名健康志愿者作为对照组。采用1.5 T MRI仪测量两组左、右室心功能及右室心肌质量。采用独立样本t检验测量两组间差异是否有统计学意义。结果 2例肺心病患者MRI检查时由于屏气时间长、不能配合而排除。与对照组比较,16例肺心病患者右室(right ventricle,RV)舒张末期容积(end-diastolic volume,EDV)、右室收缩末期容积(end-systolic volume,ESV)及右室心肌质量(myocardial mass,MM)明显增加(P<0.05),而右室射血分数(ejec-tion fraction,EF)明显减低(P<0.01)。左室EDV及EF显著减低(P<0.01)。结论肺心病患者随着肺动脉压升高,超过右心室的代偿能力,促使右心室扩大和右心功能衰竭,同时左心功能损伤。MRI左右心功能的测量可以评价肺心病的严重程度,为临床提供治疗的客观依据。Objective To assess the left and right ventricular（RV） function in patients with cor pulmonale using Magnetic resonance imaging（MRI）.Materials and Methods Eighteen cor pulmonale patients determined by the pulmonary function test,clinical examination,chest radiographs,electrocardiogram and echocardiogram were prospectively studied.The control group consisted of 18 age-matched,healthy,nonsmoking subjects.The RV and LV function and RV myocardial mass（MM） were obtained by 1.5 T cardiac MRI in two groups.The results between the two groups were compared using the independent sample t test.Results Two patients who were unable to perform repeated breath holding during MRI acquisition were excluded from the study.The RV end-diastolic volume（EDV）,RV end-systolic volume（ESV） and RV myocardial mass（MM） were significantly larger in 16 cor pulmonale patients than in control group（P 0.05）.The RVEF was significantly lower in 16 cor pulmonale patients than in controls（P 0.01）.The left ventricular EDV（LVEDV） and LVEF were significantly lower in cor pulmonale patients than in controls（P 0.01）.Conclusion When pulmonary arterial pressure continuously increases and exceeds the compensation of the right ventricle,right ventricular dilation and failure and further RVEF decrease.The left ventricular function in patients with cor pulmonale are impaired too.The assessment of right and left ventricular function using MRI is clinically important for evaluation of the severity of cor pulmonale,which may provide an objective basis for therapeutic strategy.

关 键 词：肺心病 心室功能 磁共振成像 

分 类 号：R541.5[医药卫生—心血管疾病]