Miller S, Hahn U, Bail D M, Helber U, Nägele T, Scheule A M, Schick F, Duda S H, Claussen C D
Abteilung Radiologische Diagnostik, Eberhard-Karls-Universität Tübingen.
Rofo. 1999 Jan;170(1):47-53. doi: 10.1055/s-2007-1011006.
To prove the accuracy of MR methods in the determination of left ventricular (LV) functional parameters and anatomy.
At 1.5 T, 20 healthy volunteers and 22 patients with aortic valvular disease (stenosis n = 15, regurgitation n = 7) were examined. Functional parameters like cardiac output, ejection fraction, end-diastolic volume, aortic flow maximum, and time interval from the R-wave to maximum flow were obtained using a velocity encoding 2D FLASH sequence (TR 24 ms, TE 5 ms, venc 250 cm/sec) and segmented breath-hold cine FLASH 2D technique (TR 100 ms, TE 4.8 ms, flip angle 25 degrees, temporal resolution 50 ms). Invasive measurements (Fick principle) served as gold standard, intra- and interobserver variability were determined.
Differences of functional parameters between normal volunteers and patients were detectable at a high level of significance (p < 0.0001). For cardiac output a superior correlation with the gold standard was found using flow measurements (r = 0.66, p < 0.0007) compared to volumetric calculations from cine studies (r = 0.47, p < 0.02). Interobserver variability was 2.5 +/- 2.7%/4.5 +/- 6.9% (flow quantification/calculations from cine studies), intraobserver variability was 1.7 +/- 1.6%/3.3 +/- 2.2%.
MRI is an appropriate tool for determining LV functional parameters and anatomy. Differences between normal volunteers and patients with aortic valvular disease can be detected reliably. Flow measurements turned out to be more accurate than calculations from cine images. Therefore, flow quantification techniques should be preferred for clinical use.
验证磁共振成像(MR)方法在测定左心室(LV)功能参数及解剖结构方面的准确性。
在1.5T磁场强度下,对20名健康志愿者和22例主动脉瓣疾病患者(狭窄15例,反流7例)进行检查。使用速度编码二维快速低角度激发(FLASH)序列(重复时间24毫秒,回波时间5毫秒,流速编码250厘米/秒)和分段屏气电影FLASH二维技术(重复时间100毫秒,回波时间4.8毫秒,翻转角25度,时间分辨率50毫秒)获取诸如心输出量、射血分数、舒张末期容积、主动脉血流最大值以及从R波到最大血流的时间间隔等功能参数。有创测量(Fick原理)作为金标准,测定观察者间和观察者内的变异性。
正常志愿者与患者之间功能参数的差异具有高度显著性(p<0.0001)。对于心输出量,与金标准相比,血流测量显示出更好的相关性(r=0.66,p<0.0007),而电影研究中的容积计算相关性为(r=0.47,p<0.02)。观察者间变异性为2.5±2.7%/4.5±6.9%(血流定量/电影研究计算),观察者内变异性为1.7±1.6%/3.3±2.2%。
MRI是测定LV功能参数及解剖结构的合适工具。能可靠检测出正常志愿者与主动脉瓣疾病患者之间的差异。血流测量结果比电影图像计算更准确。因此,临床应用中应优先选择血流定量技术。