3.0T MR相位对比法评价法洛四联症根治术后肺动脉反流与右心室容量及收缩功能关系

3.0T phase contrast MRI for assessment of pulmonary regurgitation and its relation to right ventricle volume and systolic function in patients with repaired tetralogy of Fallot

目的通过3.0T相位对比磁共振(PC-MRI)定量测量法洛四联症(TOF)术后远期患者的肺动脉反流程度,并与超声心动图结果进行分析,评价肺动脉反流与右心室容量及收缩功能的关系。方法对42例TOF根治术后患者于1个月内先后接受超声心动图及心脏MR检查。以PC-MRI测量肺动脉反流分数(PRF),分为轻度、中度、重度;对PC-MRI所见与超声心动图测量的PRF程度进行相关分析。比较不同PRF程度间右心室舒张末容积指数(RV-EDVI)、右心室收缩末容积指数(RV-ESVI)、右心室射血分数(RVEF)的差异。结果 PC-MRI与超声心动图显示的肺动脉反流严重程度呈正相关(rs=0.606,P<0.001)。轻度、中度及重度PRF组RV-EDVI中位数分别为89.45、108.05及133.50ml/m2(χ2=12.530,P=0.002),RV-ESVI中位数分别为50.40、64.85及81.30ml/m2(χ2=13.173,P<0.01),但三组间RVEF差异均无统计学意义(χ2=0.032,P>0.05)。结论 3.0TPC-MRI测量肺动脉反流严重程度与超声心动图有良好相关性。RV-EDVI及RV-ESVI与肺动脉反流程度密切相关;随反流严重程度加重,RV-EDVI及RV-ESVI增大,而RVEF保持稳定。

Objective To compare pulmonary regurgitation （PR） measured with 3.0T phase contrast MRI （PC-MRI） and echocardiography, in order to evaluate the relationship between PR and right ventricle （RV） volume as well as RV systolic function. Methods Cardiac MRI and eehocardiography were performed within a month after surgical correction of tetralogy of Fallot （TOF） in 42 patients. The pulmonary regurgitation fraction （PRF） was calculated with PC-MRI. Correlation a nalysis for mild, moderate and severe PRF was performed between PC-MRI and eehocardiography. Right ventricle end di astolic volume index （RV-EDVI）, right ventricle end systolic volume index （RV-ESVI） and right ventricle ejection frac tions （RVEF） were compared among different degrees of PRF. Results Degrees of PR measured with PC-MRI had posi- tive correlation with the results of echocardiography （rs =0. 606, P〈0; 001）. RV-EDVI of mild, moderate and severe PRF was 89.45, 108.05 and 133.50 ml/m2 , while RV-EDSI was 50.40, 64.85 and 81.30 ml/m2 , respectively. RV-EDVI and RV-ESVI had statistical difference among mild, moderate and severe PRF （X2 = 12. 530, 13. 173, bbth P〈0.01）, but no difference of RVEF was found （X2=0. 032, P〉0.05）. Conclusion PRF measured with 3.0T PC-MRI has good correla- tion with results of echocardiography. RV-EDVI and RV-ESVI have close relationship with PR. RV-EDVI and RV-ESVI increase with PR deteriorates, but RV-EF keeps stable.