磁共振评价冠状动脉狭窄程度与左心室结构和功能的相关性研究  

Correlation Between the Severity of Coronary Artery Stenosis and Left Ventricular Function Evaluated by Magnetic Resonance

作　　者：李绍军 姜宏宁 黄学菁 李晨 黄炎文 王国年 

机构地区：[1]上海市中医药大学附属曙光医院影像科,201203

出　　处：《临床放射学杂志》2014年第2期208-212,共5页Journal of Clinical Radiology

基　　金：上海市教委课题szy10094资助项目

摘　　要：目的研究MR冠状动脉造影(MRCA)评价冠状动脉狭窄程度与电影磁共振成像(Cine MRI)测量左心室结构和功能参数的相关性。方法对50例临床拟诊为冠心病患者进行MRCA评价冠状动脉狭窄程度以及左心室Cine MRI评价左心室结构及功能参数。依据美国心脏学会冠状动脉17段分法,对各支狭窄节段进行改良Gensini积分(GS)评估,并与左心室结构和功能参数进行相关性分析。结果将评分四分位分组,患者左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、心肌质量(MM)和左心室射血分数(LVEF)在不同积分组间差异有统计学意义(P<0.05),每搏输出量(SV)和心输出量(CO)差异无统计学意义(P>0.05)。积分与LVEF呈线性负相关(r=-0.562,P<0.05),与LVEDV、LVESV、MM呈线性正相关(r=0.543、0.685、0.476,P<0.05),与SV、CO无相关性(P>0.05)。评分越高,收缩末期厚度(WTES)、舒张末期厚度(WTED)、室壁增厚率(WT%)及室壁运动(WM)偏离正常范围节段愈多。结论冠状动脉狭窄评分愈高,左心室功能愈差。左心室MRI功能参数定量测定可评价心肌缺血,为冠心病患者提供早期诊断信息。Objective To evaluate the correlation between the severity of coronary artery stenosis and left ventricular structure and function using Cine MRI and coronary magnetic resonance angiography （MRCA）. Methods 50 cases sus- pected of coronary heart disease underwent MRCA and Cine MRI examination to evaluate coronary artery stenosis and left ventricular structure and function. According to the American Heart Association 17 segments of coronary artery method, the modified Gensini integral of each branch stenosis segment （GS） were evaluated. The correlation between the severity of coronary artery stenosis and left ventricular structure and function parameters were analyzed. Results The patients were divided into four groups according to stenosis integral. There were statistical significant difference of LVEDV, LVESV, MM, LVEF in different groups （ P 〈 0.05 ）, except for SV, CO （ P 〉 0.05 ）. Stenosis integral had negative linear correla- tion with LVEF （ r = - 0. 562 ,P 〈 0.05）, and positive linear correlation with LVEDV, LVESV, MM （ r = 0. 543,0. 685, 0. 476 ,P 〈 0.05 ） , no significant correlation with SV and CO （ P 〉 0.05 ）. The higher the stenosis integral, the more devi- ation of WTES, WTED, WT% , WM from the normal range segment. Conclusion The higher score of coronary artery stenosis, the poor function of left ventricle. MRI left ventricular function parameters can quantitative evaluate the myocardi- al ischemia, which provide information for early diagnosis of coronary heart disease.

关 键 词：磁共振电影成像 磁共振冠状动脉成像 左心室功能 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病] R445.2[医药卫生—内科学]