CAJ | 학술논문

目的：探讨双时相三维稳态进动快速成像序列（3D SSFP）对先天心脏病的诊断价值。方法：60例平均心率108次/分的先天性心脏病患儿行收缩末期和舒张中晚期的双时相3D SSFP 成像，对图像质量及对比噪声比进行分析比较。结果：心电触发收缩期延迟时间为180～300 ms，平均（235．41±35．59）ms；舒张期延迟时间为384～550 ms，平均（443．77±50．81）ms。3D SSFP 收缩期图像上显示心内结构及肺静脉、上下腔静脉的清晰度优于舒张期，两者间图像质量的差异有统计学意义（P ＜0．05）。舒张期图像上对无狭窄主动脉及肺动脉的显示清晰度高于收缩期，但两者间差异无统计学意义（P ＞0．05）。收缩期图像上心内结构的对比噪声比（CNR）均高于舒张期，且两者比较差异有统计学意义（P ＜0．05）。上腔静脉及下腔静脉在收缩期图像上的 CNR 均高于舒张期，但仅下腔静脉 CNR 的差异有统计学意义（P ＜0．05）；主动脉和肺总动脉则在舒张期图像上的 CNR 高于收缩期，但两者比较差异无统计学意义（P ＞0．05）。伴有肺动脉瓣及瓣下狭窄的肺动脉分支在收缩期的显示率（39．1％）明显低于舒张期（73．9％）。结论：双时相3D SSFP 综合利用收缩期和舒张期不同时相的成像优势，能更准确地诊断先天性心脏病患儿的心内及心外大血管结构的畸形。
목적：탐토쌍시상삼유은태진동쾌속성상서렬（3D SSFP）대선천심장병적진단개치。방법：60례평균심솔108차/분적선천성심장병환인행수축말기화서장중만기적쌍시상3D SSFP 성상，대도상질량급대비조성비진행분석비교。결과：심전촉발수축기연지시간위180～300 ms，평균（235．41±35．59）ms；서장기연지시간위384～550 ms，평균（443．77±50．81）ms。3D SSFP 수축기도상상현시심내결구급폐정맥、상하강정맥적청석도우우서장기，량자간도상질량적차이유통계학의의（P ＜0．05）。서장기도상상대무협착주동맥급폐동맥적현시청석도고우수축기，단량자간차이무통계학의의（P ＞0．05）。수축기도상상심내결구적대비조성비（CNR）균고우서장기，차량자비교차이유통계학의의（P ＜0．05）。상강정맥급하강정맥재수축기도상상적 CNR 균고우서장기，단부하강정맥 CNR 적차이유통계학의의（P ＜0．05）；주동맥화폐총동맥칙재서장기도상상적 CNR 고우수축기，단량자비교차이무통계학의의（P ＞0．05）。반유폐동맥판급판하협착적폐동맥분지재수축기적현시솔（39．1％）명현저우서장기（73．9％）。결론：쌍시상3D SSFP 종합이용수축기화서장기불동시상적성상우세，능경준학지진단선천성심장병환인적심내급심외대혈관결구적기형。
Objective:To evaluate the value of MRI dual phase three dimensional steady state free precession (dual-phase 3D SSFP)sequence in the diagnosis of congenital heart disease (CHD).Methods:60 pediatric patients of CHD with the average heart rate as 108 beats/min underwent MRI dual-phase 3D SSFP sequence,the acquired images were at the end systolic phase and mid-late diastolic phase.The image quality and contrast-to-noise ratio (CNR)were analyzed and com-pared.Results:The ECG trigger delay time was 180 ~300ms [mean= (235.41 ±35.59 )ms]in systole and 384 ~550ms [m=(443.77±50.81)ms]in diastole.The image qualities of intra-cardiac structures,pulmonary veins,superior and inferior vena cava in 3D SSFP systole were significantly better than that in diastole,with statistical difference (P <0.05).However, the distinctness of aorta with no stenosis and main pulmonary artery was better in diastole compared with that of systole, yet with no statistical difference (P >0.05).The CNR of intra-cardiac structures was significantly higher in 3D SSFP systo-le than in diastole,with statistic difference (P <0.05).The CNR of SVC and IVC was higher in systole,but only the CNR of IVC showed statistical difference (P <0.05).The CNR of aorta and main pulmonary artery was lower in systole than in diastole,but there was no statistical difference (P >0.05).In patients with pulmonary stenosis and subvalvuular pulmonary stenosis,the percentage of visibility of pulmonary artery branches in systole was only 39.1%,but was higher in diastole (73.9%).Conclusion:Dual-phase 3D SSFP sequence had the advantages of showing images in systole and diastole and ulti-mately can provide more accurate diagnosis of intra-/extra-cardiac great vessel abnormalities in pediatric patients with CHD.