摘要
目的 探讨MRI评价急性大面积肺动脉栓塞 (简称肺栓塞 )肺动脉血液动力学改变及肺动脉压力的价值。方法 2 1例经对比剂增强MR肺动脉造影 (CE MRPA)诊断的急性大面积肺栓塞患者和 2 0名健康志愿者 ,获得MR血流编码肺动脉血流图像 ,测量主肺动脉直径、右肺动脉直径、主肺动脉血流峰值流速、平均流速、流量、反流在主肺动脉短轴平面的位置以及收缩期射血加速时间等血液动力学参数 ,比较肺栓塞患者与健康志愿者间肺动脉血液动力学参数的差异 ,并与右心导管检查对比 ,分析各血液动力学参数与肺动脉平均压的相关性。结果 急性大面积肺栓塞患者组与健康志愿者组的主肺动脉直径 (分别为 2 93、2 5 2cm)、右肺动脉直径 (分别为 2 4 9、1 92cm)差异有非常显著性意义 (t值分别为 3 5 5、4 19,P值均 <0 0 1) ;患者组和健康志愿者组主肺动脉峰值流速 (分别为85 2 9、10 0 6 3cm/s)、平均流速 (分别为 11 0 0、17 12cm/s)、流量 (分别为 89 15、98 96ml/s)、收缩期射血加速时间 (分别为 10 5 0 9、16 3 85ms)比较差异有非常显著性意义 (t值分别为 2 89、6 37、2 2 1、9 4 6 ,P值分别为 0 0 1、<0 0 1、0 0 3、<0 0 1) ;急性大面积肺栓塞患者MR血流编码的肺动脉峰值流速 时间曲线表现为收缩期峰值流?
Objective To probe into the value of MR imaging in evaluating the pulmonary artery hemodynamics and pulmonary artery pressure in acute massive pulmonary embolism.Methods MR studies were performed in 21 patients with acute massive pulmonary embolism (diagnosed by contrast enhanced MR pulmonary angiography) and 20 healthy volunteers. The pulmonary artery hemodynamic parameters, such as the diameters of main and right pulmonary artery, peak velocity, average velocity, flow volume, flow patterns, and ejection acceleration time in main pulmonary artery were measured. The findings in patients and volunteers were compared. The hemodynamic parameters in patients were correlated with mean pulmonary artery pressure acquired with right heart catheterization.Results The diameters of main pulmonary artery (2.93 vs 2.52 cm) and right pulmonary artery (2.49 vs 1.92 cm) in patients and volunteers showed significant differences (t=3.55, P<0.01 and t=4.19,P<0.01, respectively); Peak velocity (85.29 vs 100.63 cm/s), average velocity (11.00 vs 17.12 cm/s), flow volume (89.15 vs 98.96 ml/s), and ejection acceleration time (105.09 vs 163.85 ms) in main pulmonary artery were significantly different between patients and volunteers (t values were 2.89, 6.37, 2.21, and 9.46, respectively; P values were 0.01, <0.01, 0.03, and <0.01, respectively). The peak velocity-time curve of main pulmonary artery acquired with velocity encoded cine of MR in patients demonstrated earlier and lower peak velocity as well as abnormal retrograde flow. In addition, linear correlations were seen between the mean pulmonary pressure and the diameter of main pulmonary artery (r=0.62, P=0.001), diameter of right pulmonary artery (r=0.63, P=0.001), and ejection acceleration time (r=-0.55, P =0.005).Conclusion MR imaging is a promising technique not only for the detection of pulmonary thromboemboli but also for the evaluation of hemodynamic parameters in pulmonary hypertension.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2004年第11期1158-1163,共6页
Chinese Journal of Radiology
