Katz J, Whang J, Boxt L M, Barst R J
Department of Radiology, College of Physicians and Surgeons of Columbia University, New York, New York 10032.
J Am Coll Cardiol. 1993 May;21(6):1475-81. doi: 10.1016/0735-1097(93)90327-w.
This study was designed to test the accuracy of nuclear magnetic resonance (NMR) imaging as a noninvasive technique for estimating right ventricular mass in normal subjects and in patients with primary pulmonary hypertension.
An accurate means of noninvasively estimating right ventricular mass may allow better characterization of the degree of right-sided pressure or volume overload caused by underlying cardiac or pulmonary diseases.
End-diastolic short-axis electrocardiogram (ECG)-gated spin echo NMR images of the heart were obtained in vivo in 13 patients with primary pulmonary hypertension and 10 normal adult volunteers. Both right and left ventricular mass were computed by summing the myocardial slice volumes over all slices spanning the myocardium and multiplying by myocardial density. This technique of myocardial mass determination was verified by imaging 10 calf hearts and comparing the NMR-determined right and left myocardial mass with the actual mass determined by weighing the right and left ventricles.
In the calf heart study, an excellent correlation was obtained between the directly measured ventricular mass and the NMR-calculated mass, for both the right and the left ventricle. Patients with primary pulmonary hypertension had an elevated right ventricular mass index compared with that of normal subjects (62.69 +/- 8.72 g/m2 vs. 23.32 +/- 1.36 g/m2, p < 0.0005). There was no significant difference in left ventricular mass index between the two groups. Both mean intraobserver and inter-observer variability in myocardial mass determination were low. Linear regression analysis between right ventricular mass index and mean pulmonary artery pressure was significant (r = 0.75, p < 0.003).
Electrocardiogram-gated spin echo NMR imaging of the heart may be used for quantitating right ventricular mass in normal subjects and in patients with primary pulmonary hypertension, in whom it may also provide an alternative noninvasive technique for estimating mean pulmonary artery pressure.
本研究旨在测试核磁共振（NMR）成像作为一种非侵入性技术，用于估计正常受试者和原发性肺动脉高压患者右心室质量的准确性。
一种准确的非侵入性估计右心室质量的方法，可能有助于更好地描述由潜在心脏或肺部疾病引起的右侧压力或容量超负荷的程度。
对13例原发性肺动脉高压患者和10名正常成年志愿者进行了心脏舒张末期短轴心电图（ECG）门控自旋回波NMR成像。通过将跨越心肌的所有切片的心肌切片体积相加，并乘以心肌密度来计算右心室和左心室质量。通过对10个小牛心脏进行成像，并将NMR测定的右心室和左心室心肌质量与通过称量右心室和左心室确定的实际质量进行比较，验证了这种心肌质量测定技术。
在小牛心脏研究中，直接测量的心室质量与NMR计算的质量之间，无论是右心室还是左心室，都获得了极好的相关性。与正常受试者相比，原发性肺动脉高压患者的右心室质量指数升高（62.69±8.72 g/m²对23.32±1.36 g/m²，p<0.0005）。两组之间左心室质量指数没有显著差异。心肌质量测定的观察者内和观察者间的平均变异性都很低。右心室质量指数与平均肺动脉压之间的线性回归分析具有显著性（r = 0.75，p<0.003）。
心脏的心电图门控自旋回波NMR成像可用于定量正常受试者和原发性肺动脉高压患者的右心室质量，在这些患者中，它还可能提供一种替代的非侵入性技术来估计平均肺动脉压。
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