中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2014年
4期
279-282
,共4页
高血压,肺%磁共振成像%心脏
高血壓,肺%磁共振成像%心髒
고혈압,폐%자공진성상%심장
Hypertension,pulmonary%Magnetic resonance imaging%Heart
目的 探讨心血管MR成像测量心室壁曲率对肺动脉高压的诊断价值.方法 回顾性分析48例患者的右心导管检查、MR检查及血压检测数据.通过测量MRI室间隔跨壁压力差与左心室游离壁跨壁压力差的比值(RP)以及室间隔与左心室游离壁曲率的比值(RC),得到RP与RC的回归方程,并进一步根据回归方程推导肺动脉收缩压(SPAP)计算值,将推导的SPAP值与右心导管检查SPAP实际值进行Bland-Altman分析,以SPAP＞ 40 mmHg作为分界点,采用受试者工作特征曲线(ROC曲线)分析该方法判定肺动脉高压的敏感度及特异度.测量数据的正态性检验采用K-S检验,一致性分析采用双变量相关Pearson检验.RP与RC的回归方程采用线性回归分析.结果 Rp测量值为0.28±0.37(-0.50～0.83),RC为0.31 ±0.57(-0.78 ～0.97),RP与RC呈线性相关(r=0.94,P ＜0.01),回归方程式为RC=1.44×RP-0.09.Bland-Altman分析显示SPAP估计值与实测值间具有良好的一致性.根据方程推导的SPAP估计值经ROC曲线分析得出该方法诊断PAH的敏感度为94.4％ (34/36)、特异度为100.0％(12/12,曲线下面积=0.942,P＜0.01).结论 通过心血管MR成像测量心室壁曲率并结合患者收缩压能够估计出患者的SPAP值,可为临床诊断肺动脉高压提供参考.
目的 探討心血管MR成像測量心室壁麯率對肺動脈高壓的診斷價值.方法 迴顧性分析48例患者的右心導管檢查、MR檢查及血壓檢測數據.通過測量MRI室間隔跨壁壓力差與左心室遊離壁跨壁壓力差的比值(RP)以及室間隔與左心室遊離壁麯率的比值(RC),得到RP與RC的迴歸方程,併進一步根據迴歸方程推導肺動脈收縮壓(SPAP)計算值,將推導的SPAP值與右心導管檢查SPAP實際值進行Bland-Altman分析,以SPAP＞ 40 mmHg作為分界點,採用受試者工作特徵麯線(ROC麯線)分析該方法判定肺動脈高壓的敏感度及特異度.測量數據的正態性檢驗採用K-S檢驗,一緻性分析採用雙變量相關Pearson檢驗.RP與RC的迴歸方程採用線性迴歸分析.結果 Rp測量值為0.28±0.37(-0.50～0.83),RC為0.31 ±0.57(-0.78 ～0.97),RP與RC呈線性相關(r=0.94,P ＜0.01),迴歸方程式為RC=1.44×RP-0.09.Bland-Altman分析顯示SPAP估計值與實測值間具有良好的一緻性.根據方程推導的SPAP估計值經ROC麯線分析得齣該方法診斷PAH的敏感度為94.4％ (34/36)、特異度為100.0％(12/12,麯線下麵積=0.942,P＜0.01).結論 通過心血管MR成像測量心室壁麯率併結閤患者收縮壓能夠估計齣患者的SPAP值,可為臨床診斷肺動脈高壓提供參攷.
목적 탐토심혈관MR성상측량심실벽곡솔대폐동맥고압적진단개치.방법 회고성분석48례환자적우심도관검사、MR검사급혈압검측수거.통과측량MRI실간격과벽압력차여좌심실유리벽과벽압력차적비치(RP)이급실간격여좌심실유리벽곡솔적비치(RC),득도RP여RC적회귀방정,병진일보근거회귀방정추도폐동맥수축압(SPAP)계산치,장추도적SPAP치여우심도관검사SPAP실제치진행Bland-Altman분석,이SPAP＞ 40 mmHg작위분계점,채용수시자공작특정곡선(ROC곡선)분석해방법판정폐동맥고압적민감도급특이도.측량수거적정태성검험채용K-S검험,일치성분석채용쌍변량상관Pearson검험.RP여RC적회귀방정채용선성회귀분석.결과 Rp측량치위0.28±0.37(-0.50～0.83),RC위0.31 ±0.57(-0.78 ～0.97),RP여RC정선성상관(r=0.94,P ＜0.01),회귀방정식위RC=1.44×RP-0.09.Bland-Altman분석현시SPAP고계치여실측치간구유량호적일치성.근거방정추도적SPAP고계치경ROC곡선분석득출해방법진단PAH적민감도위94.4％ (34/36)、특이도위100.0％(12/12,곡선하면적=0.942,P＜0.01).결론 통과심혈관MR성상측량심실벽곡솔병결합환자수축압능구고계출환자적SPAP치,가위림상진단폐동맥고압제공삼고.
Objective To observe the value of detection of pulmonary arterial hypertension(PAH) with curvature ratio measured at cardiac MR.Methods We performed a retrospective study of 48 patients with cardiac MR,systemic systolic blood pressure and right heart catheterization(RHC) data.The parameter curvature ratio (Rc) was measured at cardiac MR and transseptal/transmural pressure ratio (RP) was calculated.By using the regression analysis between Rc and RP,the SPAP was calculated.Bland-Altman analysis was used to compare the SPAP calculated with SPAP obtained by RHC.The accuracy of the SPAP calculated in detecting PAH was analyzed by using receiver operating characteristic (ROC) curves (SPAP higher than 40 mmHg as cutoff).The normality of parameter is tested by K-S test.Bivariate correlation Pearson test was used to test the consistency of parameters obtained by different measurers.Linear regression analysis was performed to find the relationship between Rc and RP.Results Parameter RP =0.28 ± 0.37 (-0.50-0.83) and RC =0.31 ± 0.57 (-0.78-0.97).Linear relationship was found between Rc and RP (r =0.94,P ＜ 0.01) and regression equation:Rc =1.44 × RP-0.09.Bland-Altman analysis showed satisfactory limits of agreement with the SPAP calculated and obtained by RHC.ROC analysis of the diagnostic value in PAH revealed 94.4％ (34/36) of sensitivity and 100.0％ of specificity (12/12,area under ROC curve =0.942,P ＜ 0.01).Conclusions Our study suggests that with curvature ratio measured at cardiac MR,the SPAP estimated have considerable sensitivity and specificity for detecting PAH.It may be a useful non-invasive assessment in patients that suspected of PAH.
