CMRI与超声心动图对高海拔地区正常人心脏结构及功能的评价研究

Comparative study of CMRI and ultrasonic cardiography evaluation of normal cardiac morphology and ventricular function in plateau

目的探讨心脏磁共振成像(CMRI)和超声心动图(UCG)对高海拔地区正常人在评价心脏结构及功能方面的应用价值。方法选择世居高海拔地区25例健康正常人行CMRI检查,并将图像导入专用后处理工作站,测定前室间隔厚度、左房内径、左室舒张末内径、右房内径、右室流出道宽径、主肺动脉内径、主动脉窦部内径等心脏结构指标,并用Argus软件测定左室射血分数,并与超声心动图(UCG)测量结果进行比较。结果CMRI与UCG测定右房内径、主肺动脉内径、左室射血分数分别为(40.11±4.18)mm、(33.41±2.34)mm;(22.82±1.12)mm、(22.41±1.33)mm;(52.06±9.69)%、(63.95±7.82)%,差异有显著性(P<0.05),主肺动脉内径及左室射血分数相关性好;测定前室间隔厚度、左房内径、左室舒张末期内径、右室流出道宽径、主动脉窦部内径分别为:(9.79±1.05)mm、(9.68±0.95)mm;(34.10±3.19)mm、(33.68±3.37)mm;(49.73±4.18)mm、(48.64±3.65)mm;(30.19±2.71)mm、(29.77±2.96)mm;(29.86±2.22)mm、(29.95±2.42)mm,差异无显著性(P>0.05),相关性好。CMRI测定的左室射血分数低于UCG检测值。结论对于高海拔地区人群,在测定左心结构方面CMRI和UCG均为较准确方法,在测定右心结构及心功能方面CMRI优于UCG,CMRI测量值更准确、可靠,临床应用当中UCG测量值会高估左室功能。

Objective To compare the application of cardiac magnetic resonance imaging(CMRI)and ultrasonic cardiography in assessing the cardiac structure and ventricular function in plateau.Methods A total of 25 native high altitudes healthy volunteers were examined by CMRI and ultrasonic cardiography(UCG).All the MR imagings were processed on dedicated post-processing workststion to test the cardiac structure indexes and ventricular function,and t tests were performed.The indexes included the interventricular septem thickness(IVST),the left atrium diameter(LAD),the left ventricular end-diastolic diameter(LVEDD),the right atrium diameter(RAD),the right ventricular outflow tract diameter(RVOTD),the main pulmonary artery diameter(MPAD),the aortic root diameter(ARD),and the left ventricular ejection fraction(LVEF).Results CMRI and UCG analysis showed that the IVST,LVEDD,RVOTD,ARD were(9.79±1.05)mm,(9.68±0.95)mm;(34.10±3.19)mm,(33.68±3.37)mm;(49.73±4.18)mm,(48.64±3.65)mm;(30.19±2.71)mm,(29.77±2.96)mm;(29.86±2.22)mm,(29.95±2.42)mm,respectively,which was no significant difference between them(P>0.05).However,the RAD,MPAD,LVEF were(40.11±4.18)mm,(33.41±2.34)mm;(22.82±1.12)mm,(22.41±1.33)mm;(52.06±9.69)%,(63.95±7.82)%,respectively,which was a significant difference between them(P<0.05).LVEF measured by CMRI were lower than those measured by UCG.Conclusion For the population in high altitude areas,both CMRI and UCG are relatively accurate methods for the determination of left ventricular structure,CMRI is superior to UCG in the determination of right ventricular structure and cardiac function,CMRI measurements are more accurate and reliable,and UCG measurements will overestimate left ventricular function in clinical application.