[马凡综合征青少年正常大小主动脉的顺应性:主动脉扩张性和脉搏波速度的磁共振测量比较]

[Compliance of the normal-sized aorta in adolescents with Marfan syndrome: comparison of MR measurements of aortic distensibility and pulse wave velocity].

作者信息

Eichhorn J G, Krissak R, Rüdiger H-J, Ley S, Arnold R, Boese J, Krug R, Gorenflo M, Khalil M, Ulmer H, Kauczor H-U, Fink C

机构信息

Kardiologie, Universitätskinderklinik, Im Neuenheimer Feld 153, 69120 Heidelberg.

出版信息

Rofo. 2007 Aug;179(8):841-6. doi: 10.1055/s-2007-963192. Epub 2007 Jul 16.

Abstract

PURPOSE

To compare the aortic compliance of the normal-sized aorta of adolescents with Marfan syndrome and healthy controls using MR measurements of the aortic distensibility and pulse wave velocity.

MATERIALS AND METHODS

Fourteen patients (median age: 15 years) and 11 healthy subjects (23 [12 - 32] years) were examined at 1.5 T. The MR protocol included 2D steady-state free precession (SSFP)-CINE MRI of the aortic distensibility and PC-MRI of the pulse wave velocity. All measurements were positioned perpendicular to the descending aorta at the level of the diaphragm for assessing the changes in the aortic cross-sectional areas and additionally above and below this plane for assessing the pulse wave velocity. In addition contrast-enhanced 3D-MR angiography was performed in adolescents with Marfan syndrome to exclude morphologic changes and to prove normal-sized aorta.

RESULTS

Compared with control subjects, adolescents with Marfan syndrome had significantly decreased distensibility and significantly increased pulse wave velocity (chi (2)-test, p = 0.0002) using an age-related non-linear regression analysis. The related aortic compliance was significantly decreased (chi (2)-test, p = 0.0002). There was a good correlation between the two methods (r = 0.86). A low intraobserver variability was found for both methods (< or = 2 %).

CONCLUSIONS

MRI allows detecting abnormal elastic aortic wall properties already in the normal-sized aorta of adolescents with Marfan syndrome. Monitoring of these properties could be relevant for evaluating disease onset and progression. MRI has the potential value of compliance measurements for the follow-up and to guide therapy indications.

摘要

目的

利用磁共振成像(MR)测量主动脉扩张性和脉搏波速度,比较患有马凡综合征的青少年正常大小主动脉与健康对照者的主动脉顺应性。

材料与方法

对14例患者(中位年龄:15岁)和11名健康受试者(23 [12 - 32]岁)进行1.5T磁共振检查。MR检查方案包括用于测量主动脉扩张性的二维稳态自由进动(SSFP)电影磁共振成像和用于测量脉搏波速度的相位对比磁共振成像(PC-MRI)。所有测量均垂直于膈肌水平的降主动脉进行,以评估主动脉横截面积的变化,此外还在该平面上方和下方进行测量以评估脉搏波速度。另外,对患有马凡综合征的青少年进行对比增强三维磁共振血管造影,以排除形态学改变并证实主动脉大小正常。

结果

使用与年龄相关的非线性回归分析,与对照受试者相比,患有马凡综合征的青少年主动脉扩张性显著降低,脉搏波速度显著增加(卡方检验,p = 0.0002)。相关的主动脉顺应性显著降低(卡方检验,p = 0.0002)。两种方法之间存在良好的相关性(r = 0.86)。两种方法的观察者内变异性均较低(≤2%)。

结论

磁共振成像能够在患有马凡综合征的青少年正常大小的主动脉中检测到异常的主动脉壁弹性特性。监测这些特性可能与评估疾病的发病和进展相关。磁共振成像在随访以及指导治疗指征方面具有测量顺应性的潜在价值。

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