Boxt L M
Department of Radiology, College of Physicians and Surgeons of Columbia University, New York, New York, USA.
Magn Reson Imaging Clin N Am. 1996 May;4(2):307-25.
Right ventricular cardiac function is altered by abnormalities affecting primarily the left-sided cardiac structures, the lungs, or the right-sided cardiac structures themselves. The most common cardiac causes for right ventricular dysfunction are chronic left ventricular ischemia and rheumatic mitral valvular disease. Pulmonary diseases that result in right ventricular dysfunction include pulmonary air-space disease, including emphysema, and pulmonary interstitial and parenchymal diseases, including idiopathic pulmonary fibrosis and cystic fibrosis. Chronic pulmonary vascular disease, including chronic thromboembolism and PPH have a significant effect on right ventricular performance. Common to all of these diseases is elevation of pulmonary vascular resistance with a commensurate increase in right ventricular pressure, resulting in right ventricular hypertrophy. The limited ability of right ventricular myocardium to function in the face of increased pulmonary resistance results in right ventricular dilatation, tricuspid regurgitation, and ultimately right ventricular failure. MR imaging provides direct, noninvasive visualization of the right ventricular chamber as well as the myocardium itself, allowing reliable demonstration of morphologic changes in the size and shape of the ventricle, thickness of the myocardium, and presence of abnormal infiltration by fat or edema. Furthermore, because MR imaging techniques do not depend upon geometric assumptions about the complex shape of the right ventricle, they may be used for accurate and reproducible quantitation of right ventricular volume and myocardial mass.
主要影响左侧心脏结构、肺部或右侧心脏结构本身的异常会改变右心室的心脏功能。导致右心室功能障碍最常见的心脏病因是慢性左心室缺血和风湿性二尖瓣疾病。导致右心室功能障碍的肺部疾病包括肺气腔疾病（如肺气肿）以及肺间质和实质疾病（如特发性肺纤维化和囊性纤维化）。慢性肺血管疾病，包括慢性血栓栓塞和PPH，对右心室功能有显著影响。所有这些疾病的共同之处在于肺血管阻力升高，同时右心室压力相应增加，导致右心室肥厚。面对增加的肺阻力，右心室心肌功能的有限性导致右心室扩张、三尖瓣反流，并最终导致右心室衰竭。磁共振成像（MR成像）提供了右心室腔以及心肌本身的直接、非侵入性可视化，能够可靠地显示心室大小和形状、心肌厚度以及脂肪或水肿异常浸润的形态学变化。此外，由于MR成像技术不依赖于对右心室复杂形状的几何假设，它们可用于准确且可重复地定量右心室容积和心肌质量。
