Horowitz Michael J, Kupsky Daniel F, El-Said Howaida G, Alshawabkeh Laith, Kligerman Seth J, Hsiao Albert
Department of Radiology, UC San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103 (M.J.H., S.J.K., A.H.); Division of Cardiology (D.F.K., L.A.) and Department of Pediatrics, Division of Cardiology (H.G.E.), UC San Diego, La Jolla, Calif; and Division of Cardiology, UC Los Angeles Health, Los Angeles, Calif (D.F.K.).
Radiol Cardiothorac Imaging. 2021 Apr 1;3(2):e200446. doi: 10.1148/ryct.2021200446. eCollection 2021 Apr.
To compare invasive right heart catheterization with four-dimensional (4D) flow MRI for estimating shunt fraction in patients with intracardiac and extracardiac shunts.
In this retrospective study, patients who underwent 4D flow MRI and invasive right heart catheterization with a shunt run between August 2015 and November 2018 were included. The primary objective was comparison of estimated shunt fraction (ratio of pulmonary-to-systemic flow, Q/Q) at 4D flow and catheterization. Secondary objectives included comparison of the right ventricular-to-left ventricular stroke volume ratio (RVSV/LVSV) to shunt fraction (for those with applicable shunts) and comparison of cardiac output between 4D flow and catheterization. Statistical analysis included Pearson correlation and Bland-Altman plots.
A total of 33 patients met inclusion criteria (mean age, 49 years ± 16 [standard deviation]; 24 women). 4D flow measurements of Q/Q strongly correlated with those at catheterization ( = 0.938), and there was no bias. RVSV/LVSV correlated strongly with Q/Q from 4D flow ( = 0.852) and catheterization ( = 0.842). Measurements of left ventricle (Q) and right ventricle (Q) cardiac output from 4D flow and catheterization (Fick) correlated moderately overall ( = 0.673 [Q] and = 0.750 [Q]).
Shunt fraction measurement using 4D flow MRI compares well with that using invasive cardiac catheterization.© RSNA, 2021.
比较有创右心导管检查与四维（4D）血流磁共振成像（MRI）在评估心内和心外分流患者分流分数方面的差异。
本回顾性研究纳入了2015年8月至2018年11月期间接受4D血流MRI检查和有创右心导管分流检查的患者。主要目的是比较4D血流检查和导管检查时估算的分流分数（肺循环与体循环血流量之比，Qp/Qs）。次要目的包括比较右心室与左心室每搏输出量之比（RVSV/LVSV）与分流分数（适用于有分流的患者），以及比较4D血流检查和导管检查时的心输出量。统计分析包括Pearson相关性分析和Bland-Altman图分析。
共有33例患者符合纳入标准（平均年龄49岁±16[标准差]；24例女性）。4D血流测量的Qp/Qs与导管检查时的测量值高度相关（r = 0.938），且无偏差。RVSV/LVSV与4D血流检查（r = 0.852）和导管检查（r = 0.842）时的Qp/Qs高度相关。4D血流检查和导管检查（Fick法）测得的左心室（Qp）和右心室（Qs）心输出量总体中度相关（r = 0.673[Qp]和r = 0.750[Qs]）。
使用4D血流MRI测量分流分数与使用有创心导管检查的结果具有良好的一致性。©RSNA，2021。
