Han Yan, Yang Zhenwen, Yu Tielian, Yu Jing, Xue Mina, Zhang Zhang, Li Dong
Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhongguo Fei Ai Za Zhi. 2012 Aug;15(8):471-5. doi: 10.3779/j.issn.1009-3419.2012.08.04.
Pulmonary hypertension (PH) is characterized by rising pulmonary arterial pressure, decreasing right ventricular (RV) function, and ultimately, RV failure. Therefore, it is important to monitor RV function and pulmonary artery hemodynamics accurately and noninvasively. This study evaluates cardiac magnetic resonance imaging (CMRI) in assessing RV function and pulmonary artery hemodynamics in patients with PH.
Cine-MRI and phase-contrast MRI (PC-MRI) were performed in 25 PH patients and 30 healthy volunteers. Cine-MRI images were post-processed on Report Card software and the following parameters were obtained: RV end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and myocardial mass (MM). Except for EF, all of the above parameters were normalized to body surface area (BSA). PC-MRI images were post-processed on Report Card software, peak velocity and distensibility of main pulmonary artery (MPA) could also be obtained. Student t test was employed for statistical assessment.
Compared with controls, RV EDV, ESV and MM index in PH patients were significantly increased (P<0.01), EF was significantly impaired (P<0.01), peak velocity and distensibility of MPA were significantly lower (P<0.01). SV index between the two groups had no significant difference (P>0.05).
Cardiac MRI is of great value in the assessment of RV function and MPA hemodynamic parameters in patients with PH.
肺动脉高压（PH）的特征是肺动脉压力升高、右心室（RV）功能下降，最终导致RV衰竭。因此，准确且无创地监测RV功能和肺动脉血流动力学非常重要。本研究评估心脏磁共振成像（CMRI）在评估PH患者RV功能和肺动脉血流动力学方面的作用。
对25例PH患者和30名健康志愿者进行电影磁共振成像（Cine-MRI）和相位对比磁共振成像（PC-MRI）检查。Cine-MRI图像在Report Card软件上进行后处理，获得以下参数：RV舒张末期容积（EDV）、收缩末期容积（ESV）、每搏输出量（SV）、射血分数（EF）和心肌质量（MM）。除EF外，上述所有参数均根据体表面积（BSA）进行标准化。PC-MRI图像在Report Card软件上进行后处理，还可获得主肺动脉（MPA）的峰值速度和扩张性。采用Student t检验进行统计学评估。
与对照组相比，PH患者的RV EDV、ESV和MM指数显著升高（P<0.01），EF显著受损（P<0.01），MPA的峰值速度和扩张性显著降低（P<0.01）。两组间的SV指数无显著差异（P>0.05）。
心脏磁共振成像在评估PH患者的RV功能和MPA血流动力学参数方面具有重要价值。
