Kjaer Andreas, Lebech Anne-Mette, Hesse Birger, Petersen Claus Leth
Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen, Denmark.
Clin Physiol Funct Imaging. 2005 Nov;25(6):344-9. doi: 10.1111/j.1475-097X.2005.00635.x.
Right ventricular (RV) function is of interest in an array of cardiopulmonary diseases. First-pass radionuclide ventriculography (FP), gated blood-pool single photon emission tomography (GBPS) and cardiac magnetic resonance imaging (MRI) are three currently used non-invasive methods for evaluation of right-sided cardiac function. The aim of our study was to compare the agreement between these methods when measuring right-sided cardiac function.
Twenty-four healthy volunteers were included. Mean age was 44 years (range: 25-60) and 29% were females. All participants had FP, GBPS and breath-hold cine MRI performed according to standard protocols.
Normal ranges for RV ejection fraction (RVEF) defined as mean +/- 2SD were 0.49-0.72, 0.44-0.66 and 0.40-0.69 when measured by MRI, FP and GBPS respectively. Bland-Altman analysis showed a mean difference (bias) between MRI and FP of 0.05 (95% CI: 0.03-0.08) and of 0.06 (95% CI: 0.02-0.10) between MRI and GBPS. No systematic bias was found between FP and GBPS. Normal values for RV end-diastolic volume index (RVEDVI) were 37-95 and 29-91 ml m(-2) when measured by MRI and GBPS respectively. The mean difference between RVEDVI was 6 ml m(-2) (95% CI: 0-11).
(i) Normal values of RVEF differ between MRI, FP and GBPS with wide limits of agreement, accordingly it is difficult to evaluate changes over time if measured by different methods, (ii) RV volumes are in the same range when measured by MRI or GBPS but with wide limits of agreement, and (iii) if MRI is considered gold standard then FP is more accurate than GBPS for RVEF measurements.
右心室(RV)功能在一系列心肺疾病中备受关注。首次通过放射性核素心室造影(FP)、门控心血池单光子发射断层扫描(GBPS)和心脏磁共振成像(MRI)是目前用于评估右心功能的三种非侵入性方法。我们研究的目的是比较这些方法在测量右心功能时的一致性。
纳入24名健康志愿者。平均年龄为44岁(范围:25 - 60岁),29%为女性。所有参与者均按照标准方案进行了FP、GBPS和屏气电影MRI检查。
通过MRI、FP和GBPS测量时,右心室射血分数(RVEF)的正常范围(定义为均值±2标准差)分别为0.49 - 0.72、0.44 - 0.66和0.40 - 0.69。布兰德 - 奥特曼分析显示,MRI与FP之间的平均差异(偏差)为0.05(95%置信区间:0.03 - 0.08),MRI与GBPS之间的平均差异为0.06(95%置信区间:0.02 - 0.10)。在FP和GBPS之间未发现系统性偏差。通过MRI和GBPS测量时,右心室舒张末期容积指数(RVEDVI)的正常值分别为37 - 95和29 - 91 ml m(-2)。RVEDVI之间的平均差异为6 ml m(-2)(95%置信区间:0 - 11)。
(i)MRI、FP和GBPS的RVEF正常值不同,一致性界限较宽,因此如果用不同方法测量,很难评估随时间的变化;(ii)通过MRI或GBPS测量时,RV容积处于相同范围,但一致性界限较宽;(iii)如果将MRI视为金标准,那么在测量RVEF时,FP比GBPS更准确。