Yang Fan, Li Dong, Yang Zhenwen, Zhang Zhang, Wang Dan, Yu Tielian
Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Department of Cardiovascular Disease, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhongguo Fei Ai Za Zhi. 2017 Feb 20;20(2):93-99. doi: 10.3779/j.issn.1009-3419.2017.02.10.
Pulmonary hypertension (PH) often leads to dilatation of main pulmonary artery (MPA). MPA measurements can be used to predict PH. This aim of this study is to investigate power of MPA vessel indices, which are acquired from cardiovascular magnetic resonance, to evaluate PH.
Cardiovascular-magnetic-resonance-determined parameters of MPA were acquired and calculated in 83 PH patients, whose diagnosis were confirmed with right heart catheterization and 49 healthy volunteers; these parameters included MPA diameter (DPA), ratio of DPA and ascending aorta diameter (DPA/DAo), max mean diameter (MDmax), min mean diameter (MDmin), fraction transverse diameter (fTD), fraction longitudinal diameter (fLD), and distensibility.
Compared with control group, DPA, DPA/DAo, MDmax, and MDmin were significantly higher in patients with PH (P<0.001); fTD, fLD, and distensibility significantly decreased (P<0.001). fTD was lesser than fLD in control group (P<0.001), whereas difference was not observed in PH (P=0.305). MPA indices were significantly correlated with mean pulmonary arterial pressure (mPAP) (P<0.05), and strongest correlation was observed for DPA/DAo (r=0.534, P<0.001). By receiver operating characteristic analysis, MDmin>28.4 mm, and MDmax>32.4 mm (area under the curve, AUC=0.979, 0.981) showed best performance in predicting PH, yielding highest specificity at 100%.
Noninvasive cardiovascular-magnetic-resonance-derived MPA measurements provide excellent and practical reference in clinical settings for detecting PH.
肺动脉高压(PH)常导致主肺动脉(MPA)扩张。MPA测量可用于预测PH。本研究旨在探讨从心血管磁共振获得的MPA血管指数评估PH的能力。
对83例经右心导管检查确诊的PH患者和49名健康志愿者进行心血管磁共振测定的MPA参数采集和计算;这些参数包括MPA直径(DPA)、DPA与升主动脉直径之比(DPA/DAo)、最大平均直径(MDmax)、最小平均直径(MDmin)、横径分数(fTD)、纵径分数(fLD)和扩张性。
与对照组相比,PH患者的DPA、DPA/DAo、MDmax和MDmin显著更高(P<0.001);fTD、fLD和扩张性显著降低(P<0.001)。对照组中fTD小于fLD(P<0.001),而PH患者中未观察到差异(P=0.305)。MPA指数与平均肺动脉压(mPAP)显著相关(P<0.05),DPA/DAo的相关性最强(r=0.534,P<0.001)。通过受试者工作特征分析,MDmin>28.4 mm和MDmax>32.4 mm(曲线下面积,AUC=0.979,0.981)在预测PH方面表现最佳,特异性高达100%。
无创性心血管磁共振衍生的MPA测量为临床检测PH提供了优秀且实用的参考。