MRI测量心室壁曲率与肺动脉收缩压的相关性研究  

Correlation analysis between curvature ratio measured at cardiac MR and systolic pulmonary artery pressure

作　　者：孙春轶[1] 孙希文[1] 

机构地区：[1]同济大学附属上海市肺科医院影像科,200433

出　　处：《中华放射学杂志》2014年第4期279-282,共4页Chinese Journal of Radiology

摘　　要：目的 探讨心血管MR成像测量心室壁曲率对肺动脉高压的诊断价值.方法 回顾性分析48例患者的右心导管检查、MR检查及血压检测数据.通过测量MRI室间隔跨壁压力差与左心室游离壁跨壁压力差的比值（RP）以及室间隔与左心室游离壁曲率的比值（RC）,得到RP与RC的回归方程,并进一步根据回归方程推导肺动脉收缩压（SPAP）计算值,将推导的SPAP值与右心导管检查SPAP实际值进行Bland-Altman分析,以SPAP＞ 40 mmHg作为分界点,采用受试者工作特征曲线（ROC曲线）分析该方法判定肺动脉高压的敏感度及特异度.测量数据的正态性检验采用K-S检验,一致性分析采用双变量相关Pearson检验.RP与RC的回归方程采用线性回归分析.结果 Rp测量值为0.28±0.37（-0.50～0.83）,RC为0.31 ±0.57（-0.78 ～0.97）,RP与RC呈线性相关（r=0.94,P ＜0.01）,回归方程式为RC=1.44×RP-0.09.Bland-Altman分析显示SPAP估计值与实测值间具有良好的一致性.根据方程推导的SPAP估计值经ROC曲线分析得出该方法诊断PAH的敏感度为94.4％ （34/36）、特异度为100.0％（12/12,曲线下面积=0.942,P＜0.01）.结论 通过心血管MR成像测量心室壁曲率并结合患者收缩压能够估计出患者的SPAP值,可为临床诊断肺动脉高压提供参考.Objective To observe the value of detection of pulmonary arterial hypertension（PAH） with curvature ratio measured at cardiac MR.Methods We performed a retrospective study of 48 patients with cardiac MR,systemic systolic blood pressure and right heart catheterization（RHC） data.The parameter curvature ratio （Rc） was measured at cardiac MR and transseptal/transmural pressure ratio （RP） was calculated.By using the regression analysis between Rc and RP,the SPAP was calculated.Bland-Altman analysis was used to compare the SPAP calculated with SPAP obtained by RHC.The accuracy of the SPAP calculated in detecting PAH was analyzed by using receiver operating characteristic （ROC） curves （SPAP higher than 40 mmHg as cutoff）.The normality of parameter is tested by K-S test.Bivariate correlation Pearson test was used to test the consistency of parameters obtained by different measurers.Linear regression analysis was performed to find the relationship between Rc and RP.Results Parameter RP =0.28 ± 0.37 （-0.50-0.83） and RC =0.31 ± 0.57 （-0.78-0.97）.Linear relationship was found between Rc and RP （r =0.94,P ＜ 0.01） and regression equation：Rc =1.44 × RP-0.09.Bland-Altman analysis showed satisfactory limits of agreement with the SPAP calculated and obtained by RHC.ROC analysis of the diagnostic value in PAH revealed 94.4％ （34/36） of sensitivity and 100.0％ of specificity （12/12,area under ROC curve =0.942,P ＜ 0.01）.Conclusions Our study suggests that with curvature ratio measured at cardiac MR,the SPAP estimated have considerable sensitivity and specificity for detecting PAH.It may be a useful non-invasive assessment in patients that suspected of PAH.

关 键 词：高血压 肺 磁共振成像 心脏 

分 类 号：R445.2[医药卫生—影像医学与核医学] R544.1[医药卫生—诊断学]