| 韩艳,张璋,王贺新,于铁链,李东.心脏MRI评估肺高血压患者心肌受损[J].中国介入影像与治疗学,2018,15(12):727-731 |
| 心脏MRI评估肺高血压患者心肌受损 |
| Cardiac MRI in assessment of myocardial damage in patients with pulmonary hypertension |
| 投稿时间：2018-03-15 修订日期：2018-10-14 |
| DOI：10.13929/j.1672-8475.201803029 |
| 中文关键词: 磁共振成像 高血压,肺性 心肌 |
| 英文关键词:Magnetic resonance imaging Hypertension,pulmonary Myocardium |
| 基金项目:天津市应用基础及前沿技术研究计划（14JCZDJC57000）。 |
|
| 摘要点击次数: 1082 |
| 全文下载次数: 528 |
| 中文摘要: |
| 目的 探讨心脏MRI （CMRI）评价肺高血压（PH）患者心肌受损程度的价值。方法 收集32例PH患者行CMRI，包括慢性血栓栓塞性PH （CTEPH）和肺动脉高压（PAH）患者，后者分为特发性PAH、结缔组织病相关PAH及先天性心脏病相关PAH。通过电影图像得到左心室（LV）、右心室（RV）心功能指标：收缩末期容积指数（ESVI）、舒张末期容积指数（EDVI）、搏出量指数（SVI）、射血分数（EF）、心肌质量指数（MMI）及心室质量指数（VMI）；通过相位对比序列得到主肺动脉峰值流速、最大及最小截面积、顺应性；通过延迟增强检查得到延迟对比增强（DCE）的心肌质量（MM）。比较CTEPH与PAH患者间DCE MM差异及不同类型PAH患者间DCE MM差异；分析DCE MM与左右心室心功能、主肺动脉血流动力学指标及病程的相关性；筛选与DCE MM显著相关的参数，并采用多元逐步线性回归分析。结果 22例（22/32，68.75%）患者出现心肌DCE，均位于RV插入部心肌中壁；CTEPH与PAH患者及不同类型PAH患者间DCE MM差异均无统计学意义（P均>0.05）；RV EDVI、RV ESVI、RV MMI及VMI是DCE MM的预测因子，RV MMI是DCE MM独立预测因子。结论 CMRI能无创、准确地反映PH患者心肌受损程度。 |
| 英文摘要: |
| Objective To explore the value of cardiac MRI (CMRI) in the assessment of the extent of myocardial damage in pulmonary hypertension (PH) patients. Methods Thirty-two patients were collected, including chronic thromboembolic PH (CTEPH) patients and pulmonary arterial hypertension (PAH) patients, and the latter were divided into congenital heart disease-associated (PAH), connective tissue disease-associated PAH and idiopathic PAH patients. All PH patients underwent CMRI. Cine images were analyzed, and cardiac function parameters, including biventricular end-systolic volume index (ESVI), end-diastolic volume index (EDVI), ejection fraction (EF), stroke volume index (SVI), myocardial mass index (MMI) and ventricular mass index (VMI) were calculated. Phase-contrast MRI images were analyzed, the main pulmonary artery maximum velocity, max and min area, as well as distensibility were obtained. Delayed enhancement (DE) was employed for calculating delayed contrast enhancement (DCE) myocardial mass (MM). Differences of DCE MM were compared between CTEPH and PAH patients, also among different etiologic groups of PAH patients. Correlations between DCE MM and biventricular function, main pulmonary artery hemodynamic parameters, disease duration were explored. Parameters significantly associated with DCE MM on univariate analysis were entered into multiple stepwise linear regression analysis. Results DCE was demonstrated in 22 patients (22/32,68.75%), occurred at the right ventricular (RV) insertion point and was confined to midmyocardium. There was no statistical difference of DCE MM between CTEPH and PAH patients, nor among different etiologic groups of PAH patients (all P > 0.05). RV EDVI, RV ESVI, RV MMI and VMI were predictors of DCE MM, and RV MMI was an independent predictor of DCE MM. Conclusion CMRI could assess the extent of myocardial damage in PH patients invasively and accurately. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
