相位对比磁共振成像在肺动脉高压患者肺血流和压力评估中的应用：与右心导管检查和超声心动图的比较。

Utility of phase contrast MR imaging for assessment of pulmonary flow and pressure estimation in patients with pulmonary hypertension: comparison with right heart catheterization and echocardiography.

机构信息

Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.

出版信息

J Magn Reson Imaging. 2009 Nov;30(5):973-80. doi: 10.1002/jmri.21935.

DOI:10.1002/jmri.21935

PMID:19856412

Abstract

PURPOSE

To compare the utility of phase contrast MR imaging (PC-MRI) for assessment of pulmonary flow and pressure estimation with that of right heart catheterization and echocardiography (cardiac US) in patients with pulmonary arterial hypertension (PAH).

MATERIALS AND METHODS

Twenty consecutive patients with suspected PAH underwent PC-MRI, cardiac US, and right heart catheterization. In each patient, PC-MRI was acquired by cine 2D-PC method on a 1.5 Tesla scanner, and stroke volume (SV) and pulmonary arterial systolic pressure (PASP) were assessed by using the modified Bernoulli's equation. To evaluate the agreements of SV and PASP among the three methods, correlations and limits of agreement among the three methods were statistically assessed by using the Bland-Altman's analyses.

RESULTS

The correlations and limits of agreement for SV and PASP between PC-MRI and catheterization (r = 0.96, r(2) = 0.94, 1.1 +/- 6.9 mL and r = 0.94, r(2) = 0.88, -3.2 +/- 14.5 mmHg, respectively) were better than between cardiac US and catheterization (r = 0.01, r(2) < 0.01, 8.9 +/- 42.1 mL and r = 0.86, r(2) = 0.72, -5.9 +/- 27.7 mmHg, respectively).

CONCLUSION

PC-MRI is more compatible with right heart catheterization than cardiac US in pulmonary flow and pressure estimation.

摘要

目的

比较相位对比磁共振成像（PC-MRI）在肺动脉高压（PAH）患者评估肺血流和压力估计方面的效用，与右心导管检查和超声心动图（心脏 US）的比较。

材料与方法

连续 20 例疑似 PAH 患者接受了 PC-MRI、心脏 US 和右心导管检查。在每位患者中，使用 Cine 2D-PC 方法在 1.5T 扫描仪上采集 PC-MRI，通过改良的伯努利方程评估心搏量（SV）和肺动脉收缩压（PASP）。为了评估三种方法之间 SV 和 PASP 的一致性，通过 Bland-Altman 分析统计评估了三种方法之间的相关性和一致性界限。

结果

PC-MRI 和导管检查之间的 SV 和 PASP 的相关性和一致性界限（r = 0.96，r² = 0.94，1.1 ± 6.9 mL 和 r = 0.94，r² = 0.88，-3.2 ± 14.5 mmHg）优于心脏 US 和导管检查之间的相关性和一致性界限（r = 0.01，r² < 0.01，8.9 ± 42.1 mL 和 r = 0.86，r² = 0.72，-5.9 ± 27.7 mmHg）。