电影磁共振成像评价左心室结构和功能参数与冠状动脉狭窄程度的关系
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(南华大学附属第一医院放射科,湖南省衡阳市 421001)

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陆从容,大学本科,主管技师,研究方向为磁共振成像对心脏结构和功能的评估,E-mail为lcr_boy@163.com。ail为prime_li@163.com。

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Relationship Between Left Ventricular Structure and Function Parameters and Degree of Coronary Stenosis Evaluated by Using Cine MRI
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Department of Radiology, the First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, China)

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    摘要:

    目的 探讨电影磁共振成像检测左心室结构和功能参数与冠状动脉狭窄程度的相关性。方法 选取我院2012至2013年62例拟诊断为冠心病的患者,应用电影磁共振成像评价左心室结构和功能参数以及冠状动脉狭窄程度。根据改良Gensini积分(GS)评估冠状动脉各支的狭窄节段,将患者分为4组:GS<5分组(10例)、5≤GS<25分组(13例)、25≤GS<60分组(20例)和GS≥60分组(19例)。分析左心室结构和功能参数与GS评分间的相关性。结果 心输出量和每搏输出量在不同组别间差异不显著(F=6.768,5.641,P>0.05),但左心室收缩末期容积、左心室舒张末期容积、左心室射血分数和心肌质量在不同组别间差异显著(F=23.722,21.021,22.425,25.621,P<0.01)。心输出量、每搏输出量与GS评分没有相关性(P>0.05),左心室射血分数与GS评分呈负相关,左心室收缩末期容积、左心室舒张末期容积、心肌质量与GS评分呈正相关(P<0.05)。GS≥60分组收缩末期厚度、舒张末期厚度、室壁增厚率、室壁运动偏离正常值的节段最多,25≤GS<60分组、5≤GS<25分组和GS<5分组偏离阶段数逐渐降低,不同组别间差异显著。收缩末期厚度、舒张末期厚度、室壁增厚率、室壁运动都与GS评分呈正相关。结论左心室功能随着GS评分的增高而变差,电影磁共振成像可有效评估心肌缺血状况,从而有助于早期诊断冠心病。

    Abstract:

    Aim To evaluate the correlation between left ventricular structure and function parameters and degree of coronary stenosis by using cine magnetic resonance imaging (MRI). Methods 62 cases suspected with coronary heart disease from 2012 to 2013 underwent cine MRI examination to evaluate left ventricular structure and function parameters and degree of coronary stenosis. The stenosis segments of each branch coronary artery were evaluated according to modified Gensini score (GS). All patients were divided into four groups:GS<5 scores group (10 cases), 5 scores≤GS<25 scores group (13 cases), 25 scores≤GS<60 scores group (20 cases) and GS≥60 scores group (19 cases). The correlation was analyzed betwween left ventricular structure and function parameters and GS score. Results The differences of cardiac output (CO) and stroke volume (SV) were not significant among different groups (F=6.8,5.641, P>0.05). Left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV), left ventricular ejection fraction (LVEF) and myocardial mass (MM) were significantly different among different groups (F=23.2,1.1,2.5,5.621, P<0.01). There was no correlation between CO, SV and GS score (P>0.05). LVEF was negatively correlated with GS score, whereas LVESV, LVEDV, MM were positively correlated with GS score (P<0.05). The segments deviated from normal values of wall thickness of end systole (WTES), wall thickness of end diastole (WTED), wall thickening % (WT%) and wall motion (WM) were most in the GS≥60 scores group; Deviation segments reduced gradually along with 25 scores≤GS<60 scores group, 5 scores≤GS<25 scores group and GS<5 scores group; The differences were significant among different groups. WTES, WTED, WT% and WM were positively correlated with GS score. Conclusions Left ventricular function becomes worse with the increase of the GS score. Cine MRI can effectively evaluate the myocardial ischemia, and thus, it can help early diagnosis of coronary heart disease.

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陆从容,李青春,吴晓东.电影磁共振成像评价左心室结构和功能参数与冠状动脉狭窄程度的关系[J].中国动脉硬化杂志,2016,24(5):499~502, 516.

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  • 收稿日期:2014-12-08
  • 最后修改日期:2015-01-19
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  • 在线发布日期: 2016-06-30