心脏MRI评估肺动脉高压患者的心功能  

Cardiac MRI in assessment of ventricular function in patients with pulmonary hypertension

作　　者：韩艳[1] 于铁链[1] 杨振文[2] 于静[1] 薛米娜[1] 李东[1] 

机构地区：[1]天津医科大学总医院放射科,天津300052 [2]天津医科大学总医院心内科,天津300052

出　　处：《中国医学影像技术》2013年第1期34-37,共4页Chinese Journal of Medical Imaging Technology

基　　金：天津市应用基础及前沿技术研究计划(10JCYBJC11000)

摘　　要：目的探讨心脏MRI(CMRI)评价肺动脉高压(PH)患者心室功能的临床价值。方法对30例PH患者(PH组)及30名健康志愿者(对照组)进行CMRI,分别计算右心室(RV)与左心室(LV)的舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、射血分数(EF)、舒张末期心肌质量(MM)等心功能参数,除EF外均经体表面积(BSA)校正,记为EDVI、ESVI、SVI、MMI。计算心室质量指数(VMI,为舒张末期RV MM与LV MM的比值)。采用两独立样本t检验分析两组参数有无差异。结果 PH组RV EDVI、ESVI及MMI均显著高于对照组(P均<0.01),RV EF显著低于对照组(P<0.01),两组RV SVI的差异无统计学意义(P>0.05)。PH组LV EDVI和SVI显著低于对照组(P均<0.05),而LV ESVI、EF及MMI与对照组的差异均无统计学意义(P均>0.05)。PH组VMI显著高于对照组(P<0.01)。PH组中23例(23/30,76.67%)患者LV舒张早期可见明显变形,其中室间隔变平10例,室间隔向左弓形突出13例。结论CMRI能够无创、准确地提供PH患者RV与LV的功能信息,对于评价PH患者心室功能具有重要价值。Objective To explore the clinical application value of cardiac MRI （CMRI） in assessment of ventricular function in patients with pulmonary hypertension （PH）. Methods CMRI was performed in 30 PH patients （PH group） and 30 healthy volunteers （control group）. The images were post-processed, and the parameters including end-diastolic volume （EDV）, end-systolic volume （ESV）, stroke volume （SV）, ejection fraction （EF）, end-diastolic myocardial mass （MM） for both right ventricular （RV） and left ventricular （LV） were obtained. Except for EF, all of the above parameters were qualified with body surface area （BSA）, and were referred as EDVI, ESVI, SVI and MMI, respectively. Ventricular mass index （VMI） was the ratio of RV MM and LV MM. Independent-samples t-test was employed for statistical assessment. Results Compared with control group, RV EDVI, ESVI and MMI in PH group significantly increased （all P〈0.01）, RV EF significantly decreased （P〈0.01）. No significant difference of RV SVI was found between the two groups （P〉0.05）. Compared with control group, LV EDVI, SVI in PH group significantly decreased （all P〈0.05）. No significant difference of LV ESVI, EF and MMI was found between the two groups （all P〉0.05）. VMI in PH group was greatly higher than that in control group （P〈0.01）. In PH group, obvious morphologic changes of interventricular septum in early diastole could be found in 23 patients （23/30,76.67%）, including interventricular septum flattening in 10 cases and leftward bowing in13 cases. Conclusion CMRI could evaluate the function of RV and LV invasively and accurately, and has great value in assessment of ventricular function in patients with PH.

关 键 词：磁共振成像 高血压 肺性 心室功能 

分 类 号：R445.2[医药卫生—影像医学与核医学] R511.3[医药卫生—诊断学]