基于相位对比成像肺动脉血流参数在评估CTD-PAH危险分层中的应用价值  

The value of pulmonary arterial flow parameters based on phase-contrast imaging in assessing risk stratification in CTD-PAH

作　　者：马珂凡 刘王琰 祝因苏[1] 孙晓萱[2] 王嫱[2] 徐怡[1] MA Kefan;LIU Wangyan;ZHU Yinsu;SUN Xiaoxuan;WANG Qiang;XU Yi(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Rheumatology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029 [2]南京医科大学第一附属医院风湿科,江苏南京210029

出　　处：《实用放射学杂志》2023年第5期732-736,共5页Journal of Practical Radiology

摘　　要：目的探讨基于相位对比成像肺动脉(PA)血流参数在评估结缔组织疾病相关肺动脉高压(CTD-PAH)危险分层中的价值。方法回顾性分析51例CTD-PAH患者临床及心脏磁共振(CMR)资料,根据简易危险分层将其分为低危组(n=23)和中高危组(n=28),并对患者的右室(RV)形态和功能参数、PA形态和血流参数进行分析,以获得可以预测肺动脉高压(PAH)危险分层的相关参数及模型。结果RV形态和功能参数以及PA形态和血流参数在2组间差异有统计学意义(P<0.05)。相较于单独使用右室收缩末期容积指数(RVESVI)或PA平均流速进行预测,联合两者对区分PAH低危和中高危具有更高的准确率(78.4%)。结论RV形态、功能参数以及PA形态和血流参数可用于评估PAH危险分层;联合RVESVI和PA平均流速,对危险分层评估有更好的预测价值。Objective To investigate the value of pulmonary arterial(PA)flow parameters based on phase-contrast imaging in assessing the risk stratification of connective tissue disease associated pulmonary arterial hypertension(CTD-PAH).Methods The clinical and cardiac magnetic resonance(CMR)data of 51 CTD-PAH patients was analyzed retrospectively,which divided into the low risk group(n=23)and medium-high risk group(n=28)according to simplified risk stratification.The right ventricular(RV)morphological and functional parameters,PA morphological and flow parameters were analyzed to obtain perfect parameters and models to predict the pulmonary arterial hypertension(PAH)risk stratification.Results The RV morphological and functional parameters,and PA morphological and flow parameters were statistically significant between the two groups(P<0.05).Compared with the right ventricular end-systolic volume index(RVESVI)or the average PA velocity alone,the combination of them had a higher accuracy(78.4%)to distinguish between low risk and medium-high risk PAH.Conclusion RV morphological and functional parameters,as well as PA morphological and flow parameters,can be used to assess PAH risk stratification;the combination of RVESVI and average PA velocity has greater predictive value of risk stratification assessment.

关 键 词：心脏磁共振 相位对比 肺动脉高压 右心室功能 血流速度 

分 类 号：R445.2[医药卫生—影像医学与核医学] R543.2[医药卫生—诊断学]