右心室流出道手术后患者外周及主肺动脉磁共振流量定量比较：一项回顾性研究。

Comparison of MR flow quantification in peripheral and main pulmonary arteries in patients after right ventricular outflow tract surgery: A retrospective study.

机构信息

Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München an der Technischen Universität München, Munich, Germany.

Service of Cardiology, Centre hospitalier universitaire vaudois, Lausanne, Switzerland.

出版信息

J Magn Reson Imaging. 2017 Dec;46(6):1839-1845. doi: 10.1002/jmri.25701. Epub 2017 Mar 16.

DOI:10.1002/jmri.25701

PMID:28301100

Abstract

PURPOSE

To compare the quantification of pulmonary stroke volume (SV) by phase contrast magnetic resonance (PC-MR) in the main pulmonary artery (MPA) to the sum of SVs in both peripheral pulmonary arteries (PPA) in different right ventricular (RV) outflow pathologies.

MATERIALS AND METHODS

Pulmonary SV was determined by PC-MR in the MPA and the PPA in healthy individuals (H, n = 54), patients after correction for tetralogy of Fallot with significant pulmonary regurgitation and without pulmonary or RV outflow tract stenosis (PR, n = 50), and in patients with RV outflow tract or pulmonary valve stenosis (PS, n = 50). Resulting SVs were compared to aortic SV in the ascending aorta.

RESULTS

Mean age was similar between the groups: H 28 ± 17 vs. PR 24 ± 11 vs. PS 22 ± 10 years. Bland-Altman analyses revealed in all groups a relatively small systemic (bias) but large random error (limits of agreement) for pulmonary SV determined in the MPA as compared to summed SVs in the PPA. The largest limits of agreement were present in PS patients: H: MPA 3.9% (-11, + 19) vs. PPA 0.4% (-15, + 15); PR: MPA 5.2% (-25, + 36) vs. PPA 0.6% (-24, + 26); PS: MPA 5% (-36; + 46), PPA -0.03% (-34, + 35).

CONCLUSION

The accuracy of PC-MR in the MPA is reasonable; however, a large random error (precision) is observed that is most pronounced in PS patients. This potential error should be taken into consideration when interpreting MPA flow measurements.

LEVEL OF EVIDENCE

3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1839-1845.

摘要

目的

比较主肺动脉（MPA）相位对比磁共振（PC-MR）测量的肺SV 与外周肺动脉（PPA）SV 之和在不同右心室（RV）流出道病变中的差异。

材料与方法

在健康个体（H，n=54）、法洛四联症伴重度肺动脉反流且无肺或 RV 流出道狭窄（PR，n=50）和 RV 流出道或肺动脉瓣狭窄（PS，n=50）患者中，通过 PC-MR 分别在 MPA 和 PPA 测量肺 SV。所得 SV 与升主动脉中的主动脉 SV 进行比较。

结果

组间平均年龄相似：H 组 28±17 岁，PR 组 24±11 岁，PS 组 22±10 岁。Bland-Altman 分析显示，在所有组中，与 PPA 中 SV 之和相比，MPA 中 SV 的系统误差（偏倚）较小，但随机误差（一致性界限）较大。在 PS 患者中，一致性界限最大：H 组：MPA 为 3.9%（-11，+19），PPA 为 0.4%（-15，+15）；PR 组：MPA 为 5.2%（-25，+36），PPA 为 0.6%（-24，+26）；PS 组：MPA 为 5%（-36；+46），PPA 为-0.03%（-34，+35）。