心脏MRI三维平衡稳态自由进动电影成像在儿童法洛四联症术后心功能评价中的可行性研究  

Application of three dimensional balanced steady state free precession cine MRI in evaluation of cardiac function in children with repaired tetralogy of Fallot

作　　者：彭雅枫 胡立伟[1] 孙爱敏[1] 王谦[1] 欧阳荣珍[1] 郭辰[1] 姚小芬 钟玉敏[1] Peng Yafeng;Hu Liwei;Sun Aimin;Wang Qian;Ouyang Rongzhen;Guo Chen;Yao Xiaofen;Zhong Yumin(Imaging Diagnostic Center,Shanghai Children′s Center Affiliated to Shanghai Jiao Tong University School of Medicine,National Children′s Medical Center(Shanghai),Shanghai 200127,China)

机构地区：[1]国家儿童医学中心(上海)上海交通大学医学院附属上海儿童医学中心放射科,200127

出　　处：《中华放射学杂志》2020年第7期649-654,共6页Chinese Journal of Radiology

基　　金：国家重点研发计划子课题(2018YFB110710);上海市科学技术委员会课题(17411965400)。

摘　　要：目的探讨心脏MRI三维(3D)平衡稳态自由进动(b-SSFP)电影成像技术评估儿童法洛四联症(TOF)术后患者心功能的可行性。方法回顾性收集2018?年4?月至2019?年10?月于上海交通大学医学院附属上海儿童医学中心30?例TOF术后患儿,2017?年6?月至2018?年8?月社会招募10?名儿童健康志愿者。TOF术后患儿及儿童志愿者均进行心脏二维(2D)b-SSFP和3D b-SSFP序列电影成像,记录总成像时间。以5?分法对图像质量评分,≥3?分为满足临床诊断需要。分别测量左右心室舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、射血分数(EF)、心输出量(CO)和心指数(CI)。2?种序列测量的心功能参数的比较,符合正态分布采用配对t检验,不符合正态分布采用Wilcoxon检验。采用Pearson或Spearman相关分析2?种图像测量各参数的相关性。结果2D b-SSFP序列成像时间为(426.5±13.0)s,3D b-SSFP为(24.7±2.5)s。2D b-SSFP图像质量评分优于3D b-SSFP,差异均有统计学意义(TOF术后患者:Z=-3.879,P<0.001;志愿者:Z=-2.646,P=0.003)。所有2D和3D b-SSFP序列采集图像质量评分均≥3?分,可用于临床诊断。2D和3D b-SSFP序列测量TOF术后患儿及志愿者心功能参数差异均无统计学意义(P>0.05)。2?种序列测量TOF术后患儿左心室的EDV、ESV、SV、EF、CO和右心室的EDV、ESV、SV呈高度正相关(r均>0.8,P均<0.05);儿童健康志愿者左心室的EDV、ESV、SV和右心室的EDV、SV呈高度正相关(r均>0.8,P均<0.05)。结论与2D b-SSFP序列相比,3D b-SSFP序列采集时间短,图像质量可满足诊断需求,且心功能测量数据准确,在儿童心脏MRI中有良好的应用前景。Objective To evaluate the feasibility of cardiac MRI three dimensional(3D)balanced steady state free precession(b-SSFP)cine imaging in evaluating cardiac function in children with repaired tetralogy of Fallot(TOF).Methods Thirty children with repaired TOF underwent cardiac MRI examination at Shanghai Children′s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine,were retrospectively collected from April 2018 to October 2019.From June 2017 to August 2018,10 healthy children were enrolled.Cardiac images of subjects were obtained using both two dimensional(2D)b-SSFP and 3D b-SSFP cardiac cine MRI and the total acquisition time was recorded.The image quality was scored using a 5-point scale,with a score≥3 as diagnostic image quality.The left and right ventricular end-diastolic volume(EDV),end-systolic volume(ESV),stroke volume(SV),ejection fraction(EF),cardiac output(CO),and cardiac index(CI)were measured.The left and right ventricle parameters were compared using paired t test or Wilcoxon test.The Pearson correlation or Spearman correlation analysis were used to evluate the correlation between the parameters measured with the 2 methods.Results The acquisition time of 2D b-SSFP images was(426.5±13.0)s,and the total time of 3D b-SSFP images was(24.7±2.5)s.The 2D b-SSFP image quality score was better than 3D b-SSFP,and the differences were statistically significant(TOF patients:Z=-3.879,P<0.001;volunteers:Z=-2.646,P=0.003).All 2D and 3D b-SSFP image quality scores were≥3 points,which can be used for clinical diagnosis.There were no statistically significant differences in cardiac function parameters between two series measurements in both TOF patients and volunteers(P>0.05).For TOF patients,the left ventricular EDV,ESV,SV,EF,CO and right ventricular EDV,ESV,and SV showed highly positive correlation(r>0.8,P<0.05).For volunteers,the left ventricular EDV,ESV,SV and right ventricular EDV and SV showed highly positive correlation(r>0.8,P<0.05).Conclusion Compared with the 2D b-SSFP sequence

关 键 词：儿童 法洛四联症 磁共振成像 三维平衡稳态自由进动 

分 类 号：R445.2[医药卫生—影像医学与核医学] R725.4[医药卫生—诊断学]