Huber A, Prompona M, Kozlik-Feldmann R, Mühling O, Rummeny E, Reiser M, Theisen D
Institut für Radiologie, Technische Universität München, München, Deutschland.
Radiologe. 2011 Jan;51(1):31-7. doi: 10.1007/s00117-010-1998-5.
The aim of this study was to determine the value of a combined magnetic resonance imaging (MRI) protocol including steady-state free precession (SSFP) imaging, phase-contrast measurements and contrast-enhanced MR angiography (CE-MRA) for presurgical or preinterventional diagnostic imaging in patients with suspected atrial septum defects.
Out of 65 MRI studies of patients with suspected atrial septum defects, 56 patients were included in the study. The atrial septum defects were identified on cine images. Velocity encoded flow measurements were used to determine shunt volumes, which were compared with invasive oxymetry in 24 patients. Contrast-enhanced MRI was used to assess the thoracic vessels in order to detect vascular anomalies. The findings were compared with the intraoperative results.
A total of 24 patients with high shunt volumes were treated either surgically (16 patients) or interventionally (8 patients) and 32 patients with low shunt volumes did not require surgical or interventional treatment. The vascular anomaly, which in all cases was anomalous pulmonary venous return, was confirmed by the intraoperative findings. The type and location of atrial septal defects which required treatment, were confirmed intraoperatively or during the intervention. The results of shunt quantification by MRI showed a good correlation with the results of invasive oximetry (r=0.91, p <0.0001).
A combined MRI protocol including cine SSFP images, velocity-encoded flow measurements and CE-MRA is an accurate method for preoperative and preinterventional evaluation of atrial septum defects.
本研究的目的是确定一种联合磁共振成像（MRI）方案的价值，该方案包括稳态自由进动（SSFP）成像、相位对比测量和对比增强磁共振血管造影（CE-MRA），用于疑似房间隔缺损患者的术前或介入前诊断成像。
在65例疑似房间隔缺损患者的MRI研究中，56例患者纳入本研究。在电影图像上识别房间隔缺损。使用速度编码血流测量来确定分流体积，并与24例患者的有创血氧测定结果进行比较。使用对比增强MRI评估胸部血管以检测血管异常。将结果与术中结果进行比较。
共有24例高分流体积患者接受了手术治疗（16例）或介入治疗（8例），32例低分流体积患者不需要手术或介入治疗。术中发现证实了所有病例中的血管异常，即异常肺静脉回流。需要治疗的房间隔缺损的类型和位置在术中或介入过程中得到证实。MRI分流定量结果与有创血氧测定结果具有良好的相关性（r = 0.91，p < 0.0001）。
包括电影SSFP图像、速度编码血流测量和CE-MRA的联合MRI方案是术前和介入前评估房间隔缺损的准确方法。
