CAJ | 학술논문

目的对比研究MRI与超声心动图(UCG)评估双向Glenn分流术(BGS)后上腔静脉-肺动脉吻合口(腔-肺吻合口)形态和血流的差异.方法应用3.0T相位对比(PC) -MRI对22例BGS术后患者上、下腔静脉进行血流测量,应用对比增强(CE) -MRI显示腔-肺吻合口及其邻近血管形态,用Report Card软件计算腔-肺吻合口宽度、峰值流速、压差,采用UCG进行对比测量分析.MRI测量上、下腔静脉血流参数,以及MRI和UCG测量腔-肺吻合口宽度、峰值流速和压差值采用配对样本t检验和Pearson相关分析.结果上腔静脉血流量[(1.002±0.208) L/min]显著低于下腔静脉血流量[(1.794±0.392) L/min](t=- 15.148,P＜0.01),上腔静脉反流分数[(26.54±12.82)％]显著高于下腔静脉反流分数[(17.44±10.17)％](t=11.060,P＜0.01)；CE-MRI能清楚显示腔-肺吻合口及其邻近血管狭窄、血栓形成等形态异常改变,UCG未显示上述形态异常改变.MRI测量腔-肺吻合口宽度[(12.46±3.43) mm]显著大于UCG[ (11.04±2.63) mm](t=4.048,P＜0.01),测量峰值流速[ (47.77±10.44) cm/s]显著小于UCG[(52.19±9.63) cm/s](t=-2.237,P＜0.05),测量压差[(0.95±0.42)mm Hg(1 mm Hg =0.133 kPa)]与UCG[( 1.12±0.38) mm Hg]差异无统计学意义(t=-2.010,P＞0.05)；二者测量腔-肺吻合口宽度、峰值流速及压差呈显著正相关(r值分别为0.858、0.489、0.427,P值均＜0.05).结论 3.0 T MRI测量腔-肺吻合口宽度、峰值流速及压差与UCG具有较好相关性,但MR1显示腔-肺吻合口宽度及形态异常显著优于UCG.
목적 대비연구MRI여초성심동도(UCG)평고쌍향Glenn분류술(BGS)후상강정맥-폐동맥문합구(강-폐문합구)형태화혈류적차이.방법 응용3.0T상위대비(PC) -MRI대22례BGS술후환자상、하강정맥진행혈류측량,응용대비증강(CE) -MRI현시강-폐문합구급기린근혈관형태,용Report Card연건계산강-폐문합구관도、봉치류속、압차,채용UCG진행대비측량분석.MRI측량상、하강정맥혈류삼수,이급MRI화UCG측량강-폐문합구관도、봉치류속화압차치채용배대양본t검험화Pearson상관분석.결과 상강정맥혈류량[(1.002±0.208) L/min]현저저우하강정맥혈류량[(1.794±0.392) L/min](t=- 15.148,P＜0.01),상강정맥반류분수[(26.54±12.82)％]현저고우하강정맥반류분수[(17.44±10.17)％](t=11.060,P＜0.01)；CE-MRI능청초현시강-폐문합구급기린근혈관협착、혈전형성등형태이상개변,UCG미현시상술형태이상개변.MRI측량강-폐문합구관도[(12.46±3.43) mm]현저대우UCG[ (11.04±2.63) mm](t=4.048,P＜0.01),측량봉치류속[ (47.77±10.44) cm/s]현저소우UCG[(52.19±9.63) cm/s](t=-2.237,P＜0.05),측량압차[(0.95±0.42)mm Hg(1 mm Hg =0.133 kPa)]여UCG[( 1.12±0.38) mm Hg]차이무통계학의의(t=-2.010,P＞0.05)；이자측량강-폐문합구관도、봉치류속급압차정현저정상관(r치분별위0.858、0.489、0.427,P치균＜0.05).결론 3.0 T MRI측량강-폐문합구관도、봉치류속급압차여UCG구유교호상관성,단MR1현시강-폐문합구관도급형태이상현저우우UCG.
Objective To investigate the difference of morphology and blood flow of cavopulmonary anastomosis by MRI and that by ultrasonic cardiography (UCG) in patients with bidirectional Glenn shunt (BGS).Methods Phase-contrast MRI (PC-MRI) and contrast enhanced MRI (CE-MRI) were performed for superior vena cava ( SVC ) and inferior vena cava (IVC) in 22 patients with BGS on 3.0 T MR scanner.PC-MRI was used for measuring blood flow and CE-MRI for illustrating morphology.The width,peak flow velocity and gradient pressure of cavopulmonary anastomosis were calculated by using Report Card software.The similar data of UCG was collected.The parameters by MRI and that by UCG were compared statistically by t test and Pearson correlation.Results Based on the MRI data,the blood flow of SVC [ ( 1.002 ±0.208) L/min ] was significantly lower than that of IVC [ ( 1.794 ± 0.392 ) L/min ] ( t =- 15.148,P ＜0.01 ),while the regurgitation fraction of SVC [ (26.54 ± 12.82)％ ] was significantly higher than that ofIVC [ ( 17.44 ± 10.17)％ ] (t =11.060,P ＜0.01 ).The morphology displayed with MRI angiography couldnot be detected with UCG.The width of cavopulmonary anastomosis measured by MRI [ (12.46 ±3.43 ) mm ] was significantly higher than that of UCG[ ( 11.04 ± 2.63 ) mm] ( t =4.048,P ＜ 0.01 ),while the peak flow velocity of cavopulmonary anastomosis measured by MRI [ (47.77 ± 10.44) cm/s] was significantly lower than that of UCG [ (52.19 + 9.63) cm/s] ( t =- 2.237,P ＜ 0.05 ).No significant difference was found in gradient pressure of cavopulmonary anastomosis between the values by MRI [(0.95+0.42) mm Hg(1 mm Hg =0.133 kPa)] and that by UCG [(1.12+0.38)mm Hg] (t=2.010,P ＞ 0.05).The width,peak flow velocity and gradient pressure of cavopulmonary anastomosis by MRI were closely correlated with those by UCG (r =0.858,0.489,0.427,all P＜ 0.05 ).Conclusions A good correlation is found in the width,peak flow velocity,and gradient pressure of the cavopulmonary anastomosis obtained by 3.0 T MRI and UCG.MRI is more useful tool to display the width and abnormal morphology of cavopulmonary anastomosis than UCG.