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电影磁共振成像在二尖瓣反流的视觉评估中的临床应用与超声心动图和心导管检查的比较。

Clinical application of cine-MRI in the visual assessment of mitral regurgitation compared to echocardiography and cardiac catheterization.

机构信息

Department of Medicine, Division of Cardiology, New York Methodist Hospital, Brooklyn, New York, United States of America.

出版信息

PLoS One. 2012;7(7):e40491. doi: 10.1371/journal.pone.0040491. Epub 2012 Jul 17.

Abstract

BACKGROUND

Detecting and quantifying the severity of mitral regurgitation is essential for risk stratification and clinical decision-making regarding timing of surgery. Our objective was to assess specific visual parameters by cine-magnetic resonance imaging (MRI) in the determination of the severity of mitral regurgitation and to compare it to previously validated imaging modalities: echocardiography and cardiac ventriculography.

METHODS

The study population consisted of 68 patients who underwent a cardiac MRI followed by an echocardiogram within a median time of 2.0 days and 49 of these patients who had a cardiac catheterization, median time of 2.0 days. The inter-rater agreement statistic (Kappa) was used to evaluate the agreement.

RESULTS

There was moderate agreement between cine MRI and Doppler echocardiography in assessing mitral regurgitation severity, with a kappa value of 0.47, confidence interval (CI) 0.29-0.65. There was also fair agreement between cine MRI and cardiac catheterization with a kappa value of 0.36, CI of 0.17-0.55.

CONCLUSION

Cine MRI offers a reasonable alternative to both Doppler echocardiography and, to a lesser extent, cardiac catheterization for visually assessing the severity of mitral regurgitation with specific visual parameters during routine clinical cardiac MRI.

摘要

背景

检测和量化二尖瓣反流的严重程度对于风险分层和手术时机的临床决策至关重要。我们的目的是通过电影磁共振成像(MRI)评估特定的视觉参数在确定二尖瓣反流严重程度,并将其与以前验证的成像方式:超声心动图和心脏心室造影进行比较。

方法

研究人群包括 68 例患者,他们在中位数为 2.0 天的时间内接受了心脏 MRI 检查,随后接受了超声心动图检查,其中 49 例患者在中位数为 2.0 天的时间内接受了心脏导管插入术。采用组内相关系数(Kappa)评估一致性。

结果

电影 MRI 与多普勒超声心动图评估二尖瓣反流严重程度之间存在中度一致性,Kappa 值为 0.47,置信区间(CI)为 0.29-0.65。电影 MRI 与心脏导管插入术之间也存在适度的一致性,Kappa 值为 0.36,CI 为 0.17-0.55。

结论

电影 MRI 为多普勒超声心动图提供了一种合理的替代方法,对于在常规临床心脏 MRI 期间使用特定的视觉参数视觉评估二尖瓣反流严重程度,它是一种比心脏导管插入术更合理的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69d0/3398949/2089cf60646c/pone.0040491.g001.jpg

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