Lotan C S, Cranney G B, Bouchard A, Bittner V, Pohost G M
Department of Medicine, University of Alabama, Birmingham.
J Am Coll Cardiol. 1989 Dec;14(7):1721-9. doi: 10.1016/0735-1097(89)90023-5.
Previous nuclear magnetic resonance (NMR) imaging studies to assess left ventricular function have used multiple axial planes, which are compromised by partial volume effects and are time consuming to acquire and analyze. Accordingly, an imaging approach using cine NMR and planes aligned with the true cardiac axes of the left ventricle was developed in views comparable with left ventricular cineangiography. Cine NMR imaging was used to assess regional wall motion and was validated by comparison with biplane left ventricular cineangiography. Fifty-nine patients underwent cineangiographic and NMR studies within 72 h. A poor quality NMR study precluded analysis in 4. leaving a study group of 55 patients (mean age 58 +/- 12: 17 women). Cine NMR movie loops were acquired in two long-axis planes: 1) right anterior oblique plane, parallel to the septum, and 2) four chamber orthogonal plane, perpendicular to the septum (this view is comparable to the angiographic left anterior oblique view). To assess regional wall motion, the left ventricle in both cine NMR and cineangiographic images was divided into five segments and graded on a five point grading scale from 3 for normal through 0 for akinesia and -1 for dyskinesia. Regional wall thickening was used qualitatively to aid in the analysis of wall motion. For the 275 segments compared in the right anterior oblique view, agreement was within one grade in 263 (95.6%) of 275 segments, whereas absolute agreement was observed in 171 (62%) of 275 segments. In the left anterior oblique view, of 200 segments evaluated, agreement within one grade was achieved in 184 segments (92%) and agreement was complete in 132 (66%).(ABSTRACT TRUNCATED AT 250 WORDS)
以往用于评估左心室功能的核磁共振(NMR)成像研究采用多个轴向平面,这些平面受部分容积效应影响,且采集和分析耗时。因此,开发了一种使用电影NMR以及与左心室真正心脏轴对齐的平面的成像方法,其视角与左心室电影血管造影相当。电影NMR成像用于评估局部心肌运动,并通过与双平面左心室电影血管造影比较进行验证。59例患者在72小时内接受了电影血管造影和NMR研究。4例患者的NMR研究质量差,无法进行分析,剩余55例患者(平均年龄58±12岁;17名女性)组成研究组。在两个长轴平面采集电影NMR动态图像:1)与室间隔平行的右前斜平面,以及2)与室间隔垂直的四腔正交平面(此视角与血管造影的左前斜视角相当)。为评估局部心肌运动,将电影NMR和电影血管造影图像中的左心室分为五个节段,并按五点分级量表进行分级,正常为3级,运动不能为0级,运动障碍为 -1级。使用局部心肌增厚进行定性分析,以辅助心肌运动分析。在右前斜视图中比较的275个节段中,275个节段中有263个(95.6%)的一致性在一个等级内,而275个节段中有171个(62%)观察到绝对一致性。在左前斜视图中,评估的200个节段中,184个节段(92%)在一个等级内达成一致,132个节段(66%)完全一致。(摘要截断于250字)