1.5T MRI联合超声心动图在先天性心脏病并肺动脉高压患者诊断中的应用  

Application of 1.5T MRI Combined with Echocardiogram in Diagnosising Patients with Congenital Heart Disease and Pulmonary Arterial Hypertension

作　　者：靖立芹 余江[2] 胡英[3] 邵芳 JING Li-qin;YU Jiang;HU Ying;SHAO Fang(Department of Ultrasound,Shengli Oilfield Central Hospital,Dongying 257000,Shandong Province,China;Department of Obstetrics and Gynecology,Shengli Oilfield Central Hospital,Dongying 257000,Shandong Province,China;Gudao Hospital,Shengli Petroleum Administration Bureau,Dongying 257231,Shandong Province,China)

机构地区：[1]山东省东营市胜利油田中心医院超声检查科,山东东营257000 [2]山东省东营市胜利油田中心医院妇产科,山东东营257000 [3]山东省东营市胜利石油管理局孤岛医院,山东东营257231

出　　处：《中国CT和MRI杂志》2021年第7期87-89,92,共4页Chinese Journal of CT and MRI

摘　　要：目的探索1.5T磁共振成像(MRI)联合超声心动图在先天性心脏病(CHD)并肺动脉高压(PAH)患者诊断中的应用价值。方法选取2017年1月至2019年12月我院确诊的74例CHD患者,根据患者是否合并PAH分为CHD-PAH组(n=30)和非PAH组(n=44)。MRI检测患者的右心室射血分数(RVEF)、舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、右房室瓣环收缩期位移(TAPSE)和右心室轴缩短率(RVFS)。超声心动图检测左室舒张末期内径(LVDd)、右房收缩末期内径(RAd)、右室内径(RVd)、主肺动脉(m PA)、肺动脉收缩压(PASP)和LVDd/RVd。采用受试者工作特征(ROC)曲线分析MRI和超声心动图对CHD-PAH诊断价值,曲线下面积(AUC)表示诊断价值。结果 74例CHD经确诊共有30例合并PAH,发病率为40.54%;MRI检测显示,CHD-PAH组患者右心室RVEF、TAPSE和RVSF均明显低于非PAH组(P<0.05);超声心动图检测结果显示,CHD-PAH组患者的PASP、LVDd和LVDd/RVd均明显高于非PAH组(P<0.05);TAPSE、RVSF、PASP和LVDd/RVd诊断CHD-PAH的AUC依次为0.672、0.828、0.775和0.681(P<0.05),MRI联合超声心动图诊断的AUC为0.902(P<0.05)。结论 MRI联合超声心动图对CHD-PAH具有较高的诊断价值。Objective To explore the application value of 1.5 T MRI combined with echocardiogram(ECG)in the diagnosis of patients with congenital heart disease(CHD)and pulmonary arterial hypertension(PAH).Methods Seventy-four CHD patients confirmed in the hospital from January 2017 to December 2019 were enrolled.According to presence or absence of PAH,they were divided into the CHD-PAH group(n=30)and non-PAH group(n=44).The end-diastolic volume(EDV)of right ventricular,end-systolic volume(ESV),stroke volume(SV),right ventricular ejection fraction(RVEF),tricuspid annular plane systolic excursion(TAPSE),and right ventricular fractional shortening(RVFS)were detected by MRI.The left ventricular end-diastolic diameter(LVDd),right atrium end-systolic diameter(RAd),right ventricular diameter(RVd),main pulmonary artery(m PA),pulmonary artery systolic pressure(PASP),and LVDd/RVd were detected by ECG.The diagnostic value of MRI and ECG in CHD-PAH was analyzed by receiver operating characteristic(ROC)curves.The areas under the curve(AUC)indicated the diagnostic value.Results Of the 74 CHD patients,there were 30 cases confirmed with PAH(40.54%).MRI test showed that RVEF,TAPSE,and RVSF in CHD-PAH group were significantly lower than those in the non-PAH group(P<0.05).ECG test results showed that PASP,LVDd,and LVDd/RVd in the CHD-PAH group were significantly higher than those in the non-PAH group(P<0.05).AUC of TAPSE,RVSF,PASP,and LVDd/RVd for diagnosis of CHD-PAH were 0.672,0.828,0.775,and 0.681,respectively(P<0.05).AUC of MRI combined with ECG was 0.902(P<0.05).Conclusion MRI combined with ECG is relatively higher diagnostic value for CHD-PAH.

关 键 词：先天性心脏病 肺动脉高压 磁共振成像 超声心动图 

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