CAJ | 학술논문

目的应用3.0 T MRI技术评价复杂先天性心脏病双向Glenn分流术（ BGS ）后患者肺血流量与肺血管发育的关系。方法应用PC-MRI对22例BGS术后患者肺、体循环大血管进行血流测量，用Re-port Card软件计算左、右肺动脉及主动脉血流参数，计算肺、体循环血流量比（ Qp/Qs）；应用CE-MRI测量肺血管发育指标。分析双肺动脉血流差异、肺血流量与肺血管发育指标关系、不同分组肺血流及肺血管发育差异。结果 BGS 术后， Qp/Qs 为0.599±0.111，肺动脉狭窄组显著大于肺动脉闭锁组（ t ＝3.422， P ＝0.003）；右肺血流量[（56.1±10.9）％]明显大于左肺血流量[（43.9±10.9）％]；右肺动脉反流分数明显低于左肺动脉（ t＝-2.689，P＝0.014）。 PC-MRI测量肺血流量与CE-MRI测量肺动脉发育指标呈显著正相关（ r＝0.456～0.698）。肺动脉狭窄组的肺血流量及肺血管发育显著优于肺动脉闭锁组（ P均＞0.05）。结论3.0 T PC-MRI测量肺血流量与CE-MRI测量肺血管发育指标具有较好相关性，二者结合方可全面评估肺血管的形态和功能，保留肺动脉的连续性有利于术后肺血管发育。
목적응용3.0 T MRI기술평개복잡선천성심장병쌍향Glenn분류술（ BGS ）후환자폐혈류량여폐혈관발육적관계。방법응용PC-MRI대22례BGS술후환자폐、체순배대혈관진행혈류측량，용Re-port Card연건계산좌、우폐동맥급주동맥혈류삼수，계산폐、체순배혈류량비（ Qp/Qs）；응용CE-MRI측량폐혈관발육지표。분석쌍폐동맥혈류차이、폐혈류량여폐혈관발육지표관계、불동분조폐혈류급폐혈관발육차이。결과 BGS 술후， Qp/Qs 위0.599±0.111，폐동맥협착조현저대우폐동맥폐쇄조（ t ＝3.422， P ＝0.003）；우폐혈류량[（56.1±10.9）％]명현대우좌폐혈류량[（43.9±10.9）％]；우폐동맥반류분수명현저우좌폐동맥（ t＝-2.689，P＝0.014）。 PC-MRI측량폐혈류량여CE-MRI측량폐동맥발육지표정현저정상관（ r＝0.456～0.698）。폐동맥협착조적폐혈류량급폐혈관발육현저우우폐동맥폐쇄조（ P균＞0.05）。결론3.0 T PC-MRI측량폐혈류량여CE-MRI측량폐혈관발육지표구유교호상관성，이자결합방가전면평고폐혈관적형태화공능，보류폐동맥적련속성유리우술후폐혈관발육。
Objective To evaluate the relationship of pulmonary blood flow and parameters of pulmonary vessels growth for patients with bidirectional Glenn shunt (BGS) by using 3.0 Tesla MR system.Methods Twenty-two patients with BGS were performed with phase-contrast MR imaging ( PC-MRI ) sequence to measure the blood flow of great vessels of pulmonary circulation and systemic circulation ,and the quantity of pulmonary and systemic circulation(Qp and Qs) per minute were calculated by using Report Card software .The parameters of pulmonary vessels growth were performed by using contrast-enhanced MR imaging ( CE-MRI ) sequence .The parameters of blood flow of left and right pulmonary artery ( LPA and RPA ) , the relationship of pulmonary volume and the parameters of pulmonary vessels growth between different groups were analyzed .Results The Qp/Qs was found to be 0.599 ±0.111 for BGS patients ,and the group of pulmonary artery stenosis ( PS) was significantly larger than the group of pulmonary artery atresia ( PA) ( t=3.422 ,P=0.003 ) .The flow volume of RPA [ ( 56.1 ±10.9 )%] was significantly higher than that of LPA [ ( 43.9 ±10.9 )%] , while the regurgitation fraction of RPA was significantly lower than that of LPA ( t =-2.689 , P =0.014 ) .A positive relationship of the flow volume and the growth parameters of pulmonary arteries was found ( r =0.456-0.698 ) .The growth parameters and flow volume of pulmonary arteries of group PS were found significantly better than that of group PA (all P>0.05).Conclusions A good correlation of the flow volume obtained by PC-MRI and the growth parameters obtained by CE-MRI for pulmonary vessels are demonstrated , and the combined parameters of the two sides may be used to evaluate the morphous and function of pulmonary vessels .The group of PS favors the development of pulmonary vessels for BGS patients.