屏气快速稳态进动序列心脏磁共振成像评价右心室功能的初步研究

Evaluation of right ventricular function using breath-held FIESTA cine magnetic resonance imaging

目的用屏气快速稳态进动(FIESTA)序列心脏磁共振(MR I)电影成像方法测量右心室容积及功能,评价其重复性及左右心室功能的相关性。方法16例心脏病患者及10例健康志愿者共26例实验者入组,用多次屏气节段采集FIESTA心脏MR I电影获得覆盖心室的短轴像;两名观察者分别独立地测定2次所有入选者的心室容积及功能,包括射血分数(EF)、舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV);评价①右心室功能在观察者内部及观察者间的重复性;②左右心室SV的相关性。结果①观察者内部的右心室参数具有较高可重复性:ESV(r=0.995),EDV(r=0.998),EF(r=0.982),SV(r=0.995)(均P<0.001);②观察者间的右心室参数亦具有较高可重复性:ESV(r=0.893),EDV(r=0.941),EF(r=0.711),SV(r=0.867)(均P<0.001);③左右心室SV显著相关(r=0.983,P<0.001);④右心室SV与身高相关(r=0.471,P<0.05)。结论屏气FIESTA心脏MR I成像方法检测右心室功能参数具有较好的可重复性,该方法得出的左右心室功能有较高的一致性。

Objective To evaluate the accuracy and reproducibility of right ventricular （RV） volumes and function measured with breath-held fast imaging employing steady state acquisition（FIESTA） cardiovascular magnetic resonance imaging（MRI）. Methods Sixteen consecutive patients with heart disease and ten healthy volunteers were enrolled in the study group. Single-slice segmented FIESTA cine imaging with multiple breath-held was performed in short-axis imaging sections to encompass the entire ventricles. ①Intra-and interobserver reproducibility of RV enddiastolic volumes（EDV） and end-systolic volumes （ESV） and ejection fraction（EF） were assessed; ②the correlation between right and left ventricular stroke volumes （SV） was explored. Results Strong statistically significant correlations were found between： ①intra-observer measurements of EDV （ r = 0. 998）, ESV （ r = 0. 995）, EF （ r = 0. 982）, SV（ r = 0. 995）, （ P 〈0. 001 ）, ②inter-observer measurements of EDV（ r = 0. 941 ）, ESV （ r = 0. 893）, EF（ r =0. 711） ,SV（ r =0. 867） ,（ P 〈0. 001） ,③MRI-derived right and left ventricular SV significantly （ r =0. 983, P 〈 0. 001）,④MRI-derived RV SV and stature （ r = 0.471, P 〈0.05）. Conclusin The assessment of RV function by breath-held FIESTA cardiovascular MRI is accurate and has high reproducibility. The correlation between left and right ventricular MRI-derived SV indicates excellent coherence of simultaneous bi-ventricular volume measurements.