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[磁共振成像在儿童漏斗胸研究中的应用价值:初步经验]

[Benefits of magnetic resonance for the study of pectus excavatum in children: initial experience].

作者信息

Dore Reyes M, De La Torre C, Bret Zurita M, Triana Junco P, Jiménez Gómez J, Romo Muñoz M, Vilanova Sánchez A, Parrón Pajares M, Pérez Vigara A, Encinas Hernández J L, Martínez Martínez L, Hernández Oliveros F, López-Santamaría M

机构信息

Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.

Servicio de Radiología Pediátrica. Hospital Universitario La Paz. Madrid.

出版信息

Cir Pediatr. 2017 Apr 20;30(2):71-76.

Abstract

INTRODUCTION/AIM OF THE STUDY: In patients with PE, cardiovascular alterations ensue as a result of the mediastinum compression caused by sternum impingement and is responsible of many of the symptoms. Anatomical and functional assessment is of the utmost importance for a comprehensive understanding of the disease and an adequate treatment plan. Our aim was to describe the use of magnetic resonance image (MRI) in the study of PE and whether it is comparable to imaging techniques.

PATIENTS AND METHODS

A retrospective study of the first 10 patients in which an MRI was performed as part of PE assessment within august 2015-2016. PE indexes were evaluated: Haller, correction, asymmetry, as well as sternal rotation. An analysis of right ventricular function was carried out comparing echocardiogram and MRI.

RESULTS

MRI scan on 10 patients showed the following findings: Haller index: inspiration: 3.75 (3.5-7.3) and expiration 4,9 (3.9-10.8), correction index of 24% (5-37%) and a sternal rotation of 12º (0-31º). The cardiovascular study showed a median ejection fraction of the right ventricle (EFRV) of 50% (38-64%), with 9 of the 10 patients under the normal value of 61% (54-71%). Echocardiographic findings underestimated functional alterations in all of the patients.

CONCLUSION

This initial study suggests that the use of MRI as a test of choice in the evaluation of PE subject to surgical correction is feasible. Absence of radiation offers the capacity of a complete and dynamic anatomical as well as cardiovascular study.

摘要

研究背景/目的:在患有鸡胸的患者中,由于胸骨撞击导致纵隔受压,进而引发心血管改变,这也是许多症状的成因。解剖学和功能评估对于全面了解该疾病及制定适当的治疗方案至关重要。我们的目的是描述磁共振成像(MRI)在鸡胸研究中的应用,以及它是否可与其他成像技术相媲美。

患者与方法

对2015年8月至2016年期间作为鸡胸评估一部分而接受MRI检查的前10例患者进行回顾性研究。评估鸡胸指数:哈勒指数、矫正指数、不对称指数以及胸骨旋转情况。通过比较超声心动图和MRI对右心室功能进行分析。

结果

10例患者的MRI扫描显示以下结果:哈勒指数:吸气时为3.75(3.5 - 7.3),呼气时为4.9(3.9 - 10.8),矫正指数为24%(5 - 37%),胸骨旋转角度为12°(0 - 31°)。心血管研究显示右心室射血分数(EFRV)中位数为50%(38 - 64%),10例患者中有9例低于正常范围61%(54 - 71%)。超声心动图检查结果低估了所有患者的功能改变。

结论

这项初步研究表明,将MRI作为手术矫正鸡胸评估的首选检查方法是可行的。无辐射特点使其能够进行完整的动态解剖学以及心血管研究。

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