心血管MRI对肺动脉高压患者肺动脉形态和右心室功能的评估  

Pulmonary arterial dimensions and right ventricular function by cardiac MRI

作　　者：彭刚[1] 孙希文[1] 朱晓华[1] 马骏[1] 江森[1] 揭冰[1] 

机构地区：[1]同济大学医学院附属上海市肺科医院影像科,200433

出　　处：《中华放射学杂志》2012年第5期391-395,共5页Chinese Journal of Radiology

基　　金：国家自然科学基金资助项目（81071213）

摘　　要：目的探讨心血管MRI（CMRI）对肺动脉高压（PAH）的诊断和评估价值。方法搜集经右心导管检查确诊的PAH患者130例，同期选择年龄匹配的临床及影像学检查无心肺疾患的31名健康志愿者作为对照组，均行CMR检查。测量如下参数：肺动脉干直径（MPAD）、同层升主动脉直径（AOD）、MPAD与AOD之比（MPAD／AOD）、右心室舒张末期容积（RVEDV）、右心室收缩末期容积（RVESV）、右心室心搏出量（RVSV）、右心室射血分数（RVEF）、右心室心肌质量（RVM）。2组间差异采用独立样本t检验，另对PAH患者的MPAD、MPAD／AOD、RVEDV、RVESV、RVSV、RVEF、RVM分别与肺动脉压（PAP）进行Pearson相关分析及线性回归分析。结果PAH组MPAD、MPAD／AOD、RVEDV、RVESV、RVM的澳4量结果[（3．88±0．57）cm、1．36±0．17、（161．63±56．37）ml、（112．61±41．46）ml、（82．70±20．73）g]较正常对照组[（2．74±0．31）cm、0．90±0．07、（131．31±15．14）ml、（61．33±9．00）ml、（44．39±5．87）g]升高，PAH组RVSV、RVEF的测量结果[（49．02±19．20）ml、（30．76±5．85）％]较正常对照组[（69．95±9．63）ml、（53．28±4．14）％]下降，组间差异均有统计学意义（tMm=10．82，tMPAD／AOD=14．93，tRvEDv=2．96，tmsv=6．83，tRvsv=一5．89，tRvEF=-20．22，tRvM=10．12，P值均〈0．01）。PAH患者的MPAD、RVEDV、RVESV、RVSV与PAP之间无明显相关性（rMPAD=0．299，rRvEDv=0．127，rRvEsv=0．278，rRvsv=-0．229）。而MPAD／AOD、RVM与PAP呈正相关（rMPAAF/AOD=0．702，FRVM=0．683），RVEF与PAP呈负相关（FRVEF=-0．660）。结论CMRI是诊断PAH的可行性方法，MPAD／AOD、RVM、RVEF可以提示PAH的严重程度。Objective To evaluate the diagnostic value of cardiac magnetic resonance imaging （CMRI） for pulmonary arterial hypertension（PAH）. Methods One hundred and thirty patients with PAH confirmed by right cardiac catheterization were examined by CMRI and the results were compared with that of 31 healthy control participants. The main pulmonary artery diameter（ MPAD）, aortic diameter（ AOD）, main pulmonary artery diameter/aortic diameter（ MPAD/AOD ）, right ventricular end-diastolic volume （RVEDV）, right ventricular end-systolic volume （RVESV） ,right ventricular ejection fraction （RVEF） and right ventricular mass （RVM） were measured. The independent samples t-test was used to compare the PAH group with the control group. The Pearson correlation analysis and linear regression analysis were used to evaluate the relationship between cardiac and arterial measurements and pulmonary arterial pressure （PAP）. Results The MPAD, MPAD/AOD, RVEDV, RVESV, RVM in PAH group[ （3.88 ±0. 57） cm, 1.36± 0. 17, （ 161.63 ± 56.37 ） ml, （ 112.61±41.46 ） ml, （ 82.70 ± 20.73 ） g, respectively ] were increased compared with those in normal control group [ （2. 74 ± 0. 31 ） cm,0. 90 ＋ 0. 07, （ 131.31 ＋ 15.14） ml, （61.33±9. 00） ml, （44. 39± 5.87） g, respectively]. The RVSV and RVEF in PAH group[ （49. 02 ± 19. 20） ml, （30. 76 ±5.85）%, respectively] were decreased compared with those in normal control group [ （69. 95 ± 9.63 ） ml, （ 53.28 ± 4. 14） %, respectively ]. The MPAD, MPAD/AOD, RVEDV, RVESV,RVSV,RVEF, RVM were significantly different between PAH patients and control participants （tMPAD = 10. 82,tMPAD/AOD = 14. 93, tRVEDv = 2. 96, tRVESv = 6. 83, tRVSV = - 5. 89, tRVEF = - 20. 22, tRyM = 10. 12, respectively, P 〈 0. 01 ）. There were no significant correlations between MPAD, RVEDV, RVESV, RVSV and PAP （ r = 0. 299 for MPAD,r = 0. 127 for RVEDV, r = 0. 278 for RVESV, r = - 0. 229 for RVSV）. Moderate positive correlations were found betwee

关 键 词：高血压 肺性 心室功能 右 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R543.2[医药卫生—诊断学]