Frank H, Globits S, Glogar D, Neuhold A, Kneussl M, Mlczoch J
Department of Cardiology, University of Vienna, Austria.
AJR Am J Roentgenol. 1993 Jul;161(1):27-31. doi: 10.2214/ajr.161.1.8517315.
A study was performed to determine the value of MR imaging in detecting pulmonary artery hypertension and in determining pulmonary artery pressure semiquantitatively.
MR studies were performed in 23 patients with pulmonary artery hypertension to measure right ventricular function (right ventricular ejection fraction, end-diastolic and end-systolic volumes, stroke volume), right ventricular wall thickness, and the diameters of the great vessels. The findings were compared with similar MR measurements made in eight control subjects. The cause of the pulmonary hypertension was primary pulmonary hypertension (eight patients), combined mitral valve disease (five patients), dilative cardiomyopathy (four patients), chronic pulmonary embolism (four patients), atrial septal defect (one patient), and pulmonary fibrosis (one patient). MR studies were done on a 0.5-T magnet using a double-angulation projection (equivalent to a four-chamber view) with a multislice-multiphase spin-echo technique and a blood flow-sensitive fast gradient-echo sequence. Pulmonary artery pressures were verified by catheterization of the pulmonary artery.
In patients with pulmonary artery hypertension, MR imaging showed right ventricular enlargement with hypertrophy, right atrial enlargement, and abnormal septal motion. Fast gradient-echo images showed tricuspid regurgitation in all cases. In cases in which the mean pressures in the pulmonary artery were greater than 70 mm Hg, systolic slow-flow phenomena were detected. Linear correlations were seen between the mean pressure in the pulmonary artery and the end-diastolic thickness of the right ventricular wall (r = .83, p < or = .0001), the diameter of the inferior vena cava (r = .73, p < or = .0001), and the diameter of the main pulmonary artery (r = .48, p < or = .02).
Our results show that MR imaging is a useful noninvasive technique for the detection of pulmonary artery hypertension and for the semiquantitative assessment of pulmonary artery pressure.
进行一项研究以确定磁共振成像（MR成像）在检测肺动脉高压以及半定量测定肺动脉压力方面的价值。
对23例肺动脉高压患者进行MR研究，以测量右心室功能（右心室射血分数、舒张末期和收缩末期容积、每搏输出量）、右心室壁厚度以及大血管直径。将结果与8名对照者的类似MR测量结果进行比较。肺动脉高压的病因包括原发性肺动脉高压（8例）、二尖瓣疾病合并症（5例）、扩张型心肌病（4例）、慢性肺栓塞（4例）、房间隔缺损（1例）和肺纤维化（1例）。MR研究在0.5T磁体上进行，采用双角度投影（相当于四腔心视图），使用多层多期自旋回波技术和血流敏感快速梯度回波序列。通过肺动脉插管验证肺动脉压力。
在肺动脉高压患者中，MR成像显示右心室扩大伴肥厚、右心房扩大以及室间隔运动异常。快速梯度回波图像在所有病例中均显示三尖瓣反流。在肺动脉平均压力大于70mmHg的病例中，检测到收缩期慢血流现象。肺动脉平均压力与右心室壁舒张末期厚度（r = 0.83，p≤0.0001）、下腔静脉直径（r = 0.73，p≤0.0001）和主肺动脉直径（r = 0.48，p≤0.02）之间存在线性相关性。
我们的结果表明，MR成像是检测肺动脉高压和半定量评估肺动脉压力的一种有用的非侵入性技术。
