基于三维三方向速度编码 MRI 与回顾性瓣膜追踪技术的左心室舒张功能评估。

Left ventricular diastolic function assessment from three-dimensional three-directional velocity-encoded MRI with retrospective valve tracking.

机构信息

Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.

出版信息

J Magn Reson Imaging. 2011 Feb;33(2):312-9. doi: 10.1002/jmri.22424.

DOI:10.1002/jmri.22424

PMID:21274972

Abstract

PURPOSE

To compare parameters describing left ventricular (LV) diastolic function obtained with three-dimensional (3D) three-directional velocity-encoded (VE) MRI with retrospective valve tracking and two-dimensional (2D) one-directional VE MRI in patients with ischemic heart failure. Second, to compare classification of LV diastolic function, and in particular for discriminating restrictive filling patterns, with both MRI techniques versus Doppler echocardiography.

MATERIALS AND METHODS

The 3D and 2D VE MRI early (E) and atrial (A) peak flow rate indices, determined from transmitral waveform analyses, were compared. Also, net forward flow volume per cycle and transmitral regurgitation fraction were determined. Agreement in classifying diastolic filling patterns between 3D and 2D VE MRI versus Doppler echocardiography was evaluated using kappa statistics.

RESULTS

The 3D three-directional VE MRI with retrospective valve tracking was statistically significantly different from 2D one-directional VE MRI for net forward flow volume and regurgitation fraction through the mitral valve and all parameters describing the diastolic waveform filling pattern, except for the E deceleration time and E/A filling ratio. Kappa-agreement between 3D three-directional VE MRI with retrospective valve tracking and echocardiography for classifying diastolic filling patterns was superior to 2D one-directional VE MRI and echocardiography (i.e., κ = 0.91 versus κ = 0.79, respectively).

CONCLUSION

The 3D three-directional VE MRI with retrospective valve tracking better describes LV diastolic function as compared to 2D one-directional VE MRI in patients with ischemic heart failure.

摘要

目的

比较三维（3D）三向速度编码（VE）MRI 与回顾性瓣膜跟踪二维（2D）单向 VE MRI 在缺血性心力衰竭患者中测量左心室（LV）舒张功能的参数。其次，比较两种 MRI 技术与多普勒超声心动图在 LV 舒张功能分类方面的差异，特别是在鉴别限制性充盈模式方面。

材料与方法

比较了基于二尖瓣血流频谱分析的 3D 和 2D VE MRI 的早期（E）和心房（A）峰值流速指数。还测定了每周期净前向血流容积和经二尖瓣反流分数。采用 Kappa 统计评估 3D 和 2D VE MRI 与多普勒超声心动图在舒张期充盈模式分类上的一致性。

结果

3D 三向 VE MRI 与回顾性瓣膜跟踪在净前向血流容积和经二尖瓣反流分数以及描述舒张期血流波形充盈模式的所有参数方面与 2D 单向 VE MRI 存在统计学差异，除 E 减速时间和 E/A 充盈比外。3D 三向 VE MRI 与超声心动图在舒张期充盈模式分类上的 Kappa 一致性优于 2D 单向 VE MRI 和超声心动图（即，κ = 0.91 比 κ = 0.79）。