Department of Medicine and Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN 55905, USA.
Int J Cardiovasc Imaging. 2013 Feb;29(2):363-9. doi: 10.1007/s10554-012-0101-x. Epub 2012 Jul 21.
We sought to propose a magnetic resonance (MR) imaging-derived index of biventricular interdependence as a diagnostic parameter to distinguish patients with surgically-confirmed pericardial constriction from those without. Free-breathing real time MR pulse sequences of seventeen subjects with surgically proven constrictive pericarditis and thirty-five patients referred for clinically-indicated cardiac MR examinations but without documented constriction were analyzed using a novel index of biventricular interdependence. Cross-sectional biventricular areas at end diastole using the epicardial surface were traced at the mid left ventricular level at end-inspiration and end-expiration and an index of biventricular interdependence, defined as the ratio of (biventricular end-diastolic area at end-inspiration)/(biventricular end-diastolic area at end-expiration) was calculated for each subject. The mean index for both groups was calculated and results were statistically compared. The index of biventricular interdependence approximated unity (mean index 1.03 ± 0.03 SD) in patients with surgically confirmed pericardial constriction, indicating similar biventricular area at end-inspiration and end-expiration, and was significantly lower than in individuals without constrictive pericarditis (mean index 1.28 ± 0.10 SD; p < 0.0001). The MR-derived index of biventricular interdependence was significantly different between subjects with surgically-confirmed pericardial constriction and subjects where pericardial constraint was not suspected and may serve as a useful metric in the hemodynamic assessment of patients with a potential diagnosis of constrictive pericarditis.
我们旨在提出一种基于磁共振（MR）成像的双心室相互依赖性指数作为诊断参数，以区分经手术证实的缩窄性心包炎患者和无缩窄性心包炎患者。对 17 例经手术证实的缩窄性心包炎患者和 35 例因临床指征接受心脏 MR 检查但无缩窄性心包炎的患者进行了自由呼吸实时 MR 脉冲序列分析，使用一种新的双心室相互依赖性指数进行分析。在吸气末和呼气末，在心包炎表面上追踪舒张末期的左心室中部的双心室横截面积，并计算双心室相互依赖性指数，定义为（吸气末双心室舒张末期面积）/（呼气末双心室舒张末期面积）。计算两组的平均指数，并进行统计学比较。双心室相互依赖性指数在经手术证实的缩窄性心包炎患者中接近 1（平均指数 1.03 ± 0.03 SD），表明吸气末和呼气末的双心室面积相似，明显低于无缩窄性心包炎患者（平均指数 1.28 ± 0.10 SD；p < 0.0001）。在经手术证实的缩窄性心包炎患者和怀疑心包受限的患者之间，MR 衍生的双心室相互依赖性指数有显著差异，可能作为潜在诊断为缩窄性心包炎患者的血流动力学评估的有用指标。
