中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2012年
5期
391-395
,共5页
彭刚%孙希文%朱晓华%马骏%江森%揭冰
彭剛%孫希文%硃曉華%馬駿%江森%揭冰
팽강%손희문%주효화%마준%강삼%게빙
高血压,肺性%心室功能,右%磁共振成像
高血壓,肺性%心室功能,右%磁共振成像
고혈압,폐성%심실공능,우%자공진성상
Hypertension,pulmonary%Ventricular function,right%Magnetic resonance imaging
目的 探讨心血管MRI(CMRI)对肺动脉高压(PAH)的诊断和评估价值.方法 搜集经右心导管检查确诊的PAH患者130例,同期选择年龄匹配的临床及影像学检查无心肺疾患的31名健康志愿者作为对照组,均行CMR检查.测量如下参数:肺动脉干直径(MPAD)、同层升主动脉直径(AOD)、MPAD与AOD之比(MPAD/AOD)、右心室舒张未期容积(RVEDV)、右心室收缩末期容积(RVESV)、右心室心搏出量(RVSV)、有心室射血分数(RVEF)、右心室心肌质量(RVM).2组间差异采用独立样本t检验,另对PAH患者的MPAD、MPAD/AOD、RVEDV、RVESV、RVSV、RVEF、RVM分别与肺动脉压(PAP)进行Pearson相关分析及线性回归分析.结果 PAH组MPAD、MPAD/AOD、RVEDV、RVESV、RVM的测量结果[(3.88±0.57) cm、1.36±0.17、(161.63±56.37) ml、(112.61±41.46) ml、( 82.70±20.73)g]较正常对照组[(2.74±0.31) cm、0.90±0.07、(131.31±15.14) ml、(61.33±9.00)ml、(44.39±5.87)g]升高,PAH组RVSV、RVEF的测量结果[(49.02±19.20)ml、(30.76±5.85)％]较正常对照组[(69.95±9.63) ml、(53.28±4.14)％]下降,组间差异均有统计学意义(tMPAD=10.82,tMPAD/AOD=14.93,tRVEDV=2.96,tRVESV=6.83,tRVSV=-5.89,tRVEF=-20.22,tRVM=10.12,P值均＜0.01).PAH患者的MPAD、RVEDV、RVESV、RVSV与PAP之间无明显相关性(rMPAD=0.299,rRVEDV=0.127,rRVESV=0.278,rRVSV=-0.229).而MPAD/AOD、RVM与PAP呈正相关( rMPAD/AOD=0.702,rRVM=0.683),RVEF与PAP呈负相关(rHVEF=-0.660).结论 CMRI是诊断PAH的可行性方法,MPAD/AOD、RVM、RVEF可以提示PAH的严重程度.
目的 探討心血管MRI(CMRI)對肺動脈高壓(PAH)的診斷和評估價值.方法 搜集經右心導管檢查確診的PAH患者130例,同期選擇年齡匹配的臨床及影像學檢查無心肺疾患的31名健康誌願者作為對照組,均行CMR檢查.測量如下參數:肺動脈榦直徑(MPAD)、同層升主動脈直徑(AOD)、MPAD與AOD之比(MPAD/AOD)、右心室舒張未期容積(RVEDV)、右心室收縮末期容積(RVESV)、右心室心搏齣量(RVSV)、有心室射血分數(RVEF)、右心室心肌質量(RVM).2組間差異採用獨立樣本t檢驗,另對PAH患者的MPAD、MPAD/AOD、RVEDV、RVESV、RVSV、RVEF、RVM分彆與肺動脈壓(PAP)進行Pearson相關分析及線性迴歸分析.結果 PAH組MPAD、MPAD/AOD、RVEDV、RVESV、RVM的測量結果[(3.88±0.57) cm、1.36±0.17、(161.63±56.37) ml、(112.61±41.46) ml、( 82.70±20.73)g]較正常對照組[(2.74±0.31) cm、0.90±0.07、(131.31±15.14) ml、(61.33±9.00)ml、(44.39±5.87)g]升高,PAH組RVSV、RVEF的測量結果[(49.02±19.20)ml、(30.76±5.85)％]較正常對照組[(69.95±9.63) ml、(53.28±4.14)％]下降,組間差異均有統計學意義(tMPAD=10.82,tMPAD/AOD=14.93,tRVEDV=2.96,tRVESV=6.83,tRVSV=-5.89,tRVEF=-20.22,tRVM=10.12,P值均＜0.01).PAH患者的MPAD、RVEDV、RVESV、RVSV與PAP之間無明顯相關性(rMPAD=0.299,rRVEDV=0.127,rRVESV=0.278,rRVSV=-0.229).而MPAD/AOD、RVM與PAP呈正相關( rMPAD/AOD=0.702,rRVM=0.683),RVEF與PAP呈負相關(rHVEF=-0.660).結論 CMRI是診斷PAH的可行性方法,MPAD/AOD、RVM、RVEF可以提示PAH的嚴重程度.
목적 탐토심혈관MRI(CMRI)대폐동맥고압(PAH)적진단화평고개치.방법 수집경우심도관검사학진적PAH환자130례,동기선택년령필배적림상급영상학검사무심폐질환적31명건강지원자작위대조조,균행CMR검사.측량여하삼수:폐동맥간직경(MPAD)、동층승주동맥직경(AOD)、MPAD여AOD지비(MPAD/AOD)、우심실서장미기용적(RVEDV)、우심실수축말기용적(RVESV)、우심실심박출량(RVSV)、유심실사혈분수(RVEF)、우심실심기질량(RVM).2조간차이채용독립양본t검험,령대PAH환자적MPAD、MPAD/AOD、RVEDV、RVESV、RVSV、RVEF、RVM분별여폐동맥압(PAP)진행Pearson상관분석급선성회귀분석.결과 PAH조MPAD、MPAD/AOD、RVEDV、RVESV、RVM적측량결과[(3.88±0.57) cm、1.36±0.17、(161.63±56.37) ml、(112.61±41.46) ml、( 82.70±20.73)g]교정상대조조[(2.74±0.31) cm、0.90±0.07、(131.31±15.14) ml、(61.33±9.00)ml、(44.39±5.87)g]승고,PAH조RVSV、RVEF적측량결과[(49.02±19.20)ml、(30.76±5.85)％]교정상대조조[(69.95±9.63) ml、(53.28±4.14)％]하강,조간차이균유통계학의의(tMPAD=10.82,tMPAD/AOD=14.93,tRVEDV=2.96,tRVESV=6.83,tRVSV=-5.89,tRVEF=-20.22,tRVM=10.12,P치균＜0.01).PAH환자적MPAD、RVEDV、RVESV、RVSV여PAP지간무명현상관성(rMPAD=0.299,rRVEDV=0.127,rRVESV=0.278,rRVSV=-0.229).이MPAD/AOD、RVM여PAP정정상관( rMPAD/AOD=0.702,rRVM=0.683),RVEF여PAP정부상관(rHVEF=-0.660).결론 CMRI시진단PAH적가행성방법,MPAD/AOD、RVM、RVEF가이제시PAH적엄중정도.
Objective To evaluate the diagnostic value of cardiac magnetic resonance imaging (CMRI) for pulmonary arterial hypertension(PAH).Methods One hundred and thirty patients with PAH confirmed by right cardiac catheterization were examined by CMRI and the results were compared with that of 31 healthy control participants.The main pulmonary artery diameter( MPAD),aortic diameter( AOD),main pulnonary artery diameter/aortic diameter (MPAD/AOD), right ventricular end-diastolic volume ( RVEDV ),right ventricular end-systolic volume ( RVESV),right ventricular ejection fraction (RVEF) and right ventricular mass (RVM) were measured.The independent samples t-test was used to compare the PAH group with the control group.The Pearson correlation analysis and linear regression analysis were used to evaluate the relationship between cardiac and arterial measurements and pulmonary arterial pressure (PAP).Results The MPAD,MPAD/AOD,RVEDV,RVESV,RVM in PAH group[ (3.88 ±0.57) cm,1.36 ±0.17,(161.63 ±56.37) ml,( 112.61 ±41.46) ml,(82.70 ± 20.73) g,respectively ] were increased compared with those in normal control group[ (2.74 ±0.31 ) cm,0.90 ±0.07,( 131.31 ± 15.14) ml,(61.33±9.00) ml,(44.39±5.87) g,respectively].The RVSV and RVEF in PAH group[(49.02 ±19.20) ml,( 30.76 ± 5.85 ) ％,respectively ] were decreased compared with those in normal control group [ (69.95 ± 9.63 )ml,(53.28 ± 4.14 )％,respectively ].The MPAD,MPAD/AOD,RVEDV,RVESV,RVSV,RVEF,RVM were significantly different between PAH patients and control participants(tMPA =10.82,tMPAD/AOD=14.93,tRVEDV=2.96,tRVESV=6.83,tRVSV=-5.89,tRVEF=-20.22,tRVM=10.12,respectively,P＜0.01).There were no significant correlations between MPAD,RVEDV,RVESV,RVSV and PAP (r=0.299 for MPAD,r =0.127 for RVEDV,r=0.278 for RVESV,r =-0.229 for RVSV).Moderate positive correlations were found between MPAD/AOD, RVM and PAP (r =0.702 for MPAD/AOD,r =0.683 for RVM ).A moderate negative correlation was found between RVEF and PAP (r=-0.660).Conclusion CMRI is an excellent imaging modality for the diagnosis of PAH. The MPAD/AOD,RVM,and RVEF can be used to indicate the severity of PAH.
