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磁共振左室血流动力分析:两种方法的正常值研究

Magnetic resonance left ventricular hemodynamic analysis:a normal value study of two methods

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目的 分析基于磁共振二尖瓣口单平面及多平面电影序列评估左室血流动力(HDF)的一致性.方法 前瞻性纳入48例健康成年人,分别采用两种不同方法测量二尖瓣口直径并计算HDF参数.第一种方法:在左室三腔心电影序列测量二尖瓣口直径;第二种方法:分别在两腔心、三腔心、四腔心电影序列测量二尖瓣口直径后取平均值.使用配对t检验比较两种方法测量的HDF是否有差异,并采用皮尔逊相关系数(r)、组内相关系数(ICC)和Bland-Altman分析检验两种方法的一致性和可重复性.结果 使用单平面和多平面二尖瓣直径计算纵向HDF均方根(RMS)分别为:全心动周期[(17.28±4.41)%vs(17.21±4.61)%](P=0.379)、收缩期[(21.45±5.54)%vs(21.49± 5.68)%](P=0.646)、舒张期[(12.78±4.10)%vs(12.54±4.24)%](P=0.106).心室功能相关HDF参数计算结果差异无统计学意义(均P>0.05),具有良好一致性(r=0.924~0.996,ICC=0.924~0.995).涉及心房功能的2项HDF参数对二尖瓣口直径测量方法较为敏感[心房主动排空期纵向HDFRMS:(3.26±1.51)%vs(3.32±1.55)%,P=0.006;心 房主动排空期纵向 HDF 脉冲:(-2.60± 1.28)%vs(-2.76±1.30)%,P<0.001].结论 单平面法和多平面法测量二尖瓣口直径分析得到的心室功能相关HDF参数均具有良好的一致性,基本可以用相对简单的单平面法评估左室HDF.
Objectives To analyze the consistency of evaluating left ventricular hemodynamics(HDF)based on single plane and multi plane cine sequences of magnetic resonance mitral valve orifice.Methods A prospective study was conducted on 48 healthy adults,and two methods were used to measure.the mitral valve diameter and calculate HDF parameters.The first method was to measure the diameter of the mitral valve opening in the left ventricular three chamber cine sequence;The second method is to measure the mitral valve diameter using cine sequences of two chamber,three chamber,and four chamber hearts,and then take the average value.Paired t-tests were used to compare the differences in HDF measured by two methods,and Pearson correlation coefficient(r),intra group correlation coefficient(ICC),and Bland-Altman analysis were used to test the consistency and reproducibility of the two methods.Results The root mean square(RMS)of longitudinal HDF calculated using single plane and multi plane mitral valve diameters were[(17.28±4.41)%vs(17.21±4.61)%](P=0.379)for the entire cardiac cycle,[(21.45±5.54)%vs(21.49±5.68)%](P=0.646)for systolic phase,and[(12.78± 4.10)%vs(12.54±4.24)%](P=0.106)for diastolic phase,respectively.The difference in the cal-culation results of HDF parameters related to ventricular function was not statistically significant(all P>0.05),and there was good consistency(r=0.924-0.996,ICC=0.924-0.995).The two HDF parameters related to atrial function were sensitive to the measurement method of mitral valve orifice diameter[RMS of longitudinal HDF during active atrial emptying:(3.26±1.51)%vs(3.32±1.55)%,P=0.006;longitudinal HDF pulse during active atrial emptying:(-2.60±1.28)%vs(-2.76±1.30)%,P<0.001].Conclusions The ventricular function related HDF parameters obtained from the analysis of mitral valve orifice diameter using single plane and multi plane methods have good consistency,and can be evaluated using relatively simple single plane methods for left ventricular HDF.

Cardiac imaging techniquesMagnetic resonance imagingMitral valveHemodynamics

张华莹、杨文静、徐晶、周笛、王艺宁、朱乐怡、蒋梦迪、尹刚、赵世华、陆敏杰

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中国医学科学院北京协和医学院阜外医院磁共振影像科,北京 100037

中国医学科学院心血管影像重点实验室(培育),北京 100037

心脏成像技术 磁共振成像 二尖瓣 血流动力学

国家自然科学基金北京市自然科学基金中国医学科学院重点实验室建设项目高水平医院临床研究青年重点项目北京协和医学院本科教育改革项目

8197158872421102019PT3100252022-GSP-QZ-52023zlgl 026

2024

中国医师杂志
中华医学会 湖南省医学会

中国医师杂志

CSTPCD
影响因子:0.876
ISSN:1008-1372
年,卷(期):2024.26(1)
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