Ordovás Karen G, Tan Christopher, Reddy Gautham P, Weber Oliver M, Lu Ying, Higgins Charles B
Department of Radiology, University of California, San Francisco, San Francisco, California 94143-0628, USA.
J Magn Reson Imaging. 2007 Apr;25(4):721-6. doi: 10.1002/jmri.20863.
To compare the relative severity of stenoses of right or left pulmonary arteries with differences in flow to each lung after repair of congenital heart disease (CHD).
A total of 15 patients with postoperative congenital heart disease underwent MRI to evaluate branch pulmonary artery stenoses. Spin-echo images and MR angiography were used to assess morphology, and velocity-encoded cine (VEC) MRI was used to measure flow in the right and left pulmonary arteries. The ratios of the narrowest diameters of the right to left pulmonary arteries (R/L size) and right to left pulmonary arterial flow (R/L flow) were compared using Spearman's correlation. F test was used to assess the significance of the regression coefficients.
R/L size ratio varied from 0.50 to 2.66, while the R/L flow ratio varied from 0.36 to 12.02. There was an exponential relationship between R/L size and R/L flow, with r2=0.78 and P=0.001. However, severity of morphologic stenoses was not clinically useful for predicting flow reduction. Prediction residuals ranged from -136% to 54% of the true R/L flow.
Anatomical evaluation of the pulmonary arteries does not predict accurately differential blood flow in patients with pulmonary stenoses. Therefore, blood flow measurements are essential when considering the need for further surgical or interventional procedures.
比较先天性心脏病（CHD）修复术后右或左肺动脉狭窄的相对严重程度以及两肺血流的差异。
总共15例先天性心脏病术后患者接受了MRI检查以评估分支肺动脉狭窄。自旋回波图像和磁共振血管造影用于评估形态，速度编码电影（VEC）MRI用于测量右和左肺动脉的血流。使用Spearman相关性比较右肺动脉与左肺动脉最窄直径之比（R/L大小）以及右肺动脉与左肺动脉血流之比（R/L血流）。F检验用于评估回归系数的显著性。
R/L大小比在0.50至2.66之间变化，而R/L血流比在0.36至12.02之间变化。R/L大小与R/L血流之间存在指数关系，r2 = 0.78，P = 0.001。然而，形态学狭窄的严重程度在临床上对于预测血流减少并无用处。预测残差范围为真实R/L血流的-136%至54%。
对肺动脉的解剖学评估不能准确预测肺动脉狭窄患者的血流差异。因此，在考虑是否需要进一步的手术或介入治疗时，血流测量至关重要。
