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中华医学超声杂志(电子版) ›› 2017, Vol. 14 ›› Issue (10) : 779 -784. doi: 10.3877/cma.j.issn.1672-6448.2017.10.012

所属专题: 文献

心血管超声影像学

磁共振成像技术与超声心动图在诊断女性高原肺动脉高压中的价值
王生元1,(), 高律萍1, 陈红1, 曹成瑛1   
  1. 1. 810012 西宁,青海省心脑血管专科医院放射科
  • 收稿日期:2017-10-09 出版日期:2017-10-01
  • 通信作者: 王生元

The value of magnetic resonance imaging and ultrasonic cardiography in women with high altitude pulmonary arterial hypertension

Shengyuan Wang1,(), Lyuping Gao1, Hong Chen1, Chengying Cao1   

  1. 1. Department of Radiology, Qinghai Cardiovascular and Cerebrovascular Specialized Hospital, Xining 810012, China
  • Received:2017-10-09 Published:2017-10-01
  • Corresponding author: Shengyuan Wang
  • About author:
    Corresponding author: Wang Shengyuan, Email:
引用本文:

王生元, 高律萍, 陈红, 曹成瑛. 磁共振成像技术与超声心动图在诊断女性高原肺动脉高压中的价值[J/OL]. 中华医学超声杂志(电子版), 2017, 14(10): 779-784.

Shengyuan Wang, Lyuping Gao, Hong Chen, Chengying Cao. The value of magnetic resonance imaging and ultrasonic cardiography in women with high altitude pulmonary arterial hypertension[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(10): 779-784.

目的

探讨磁共振成像(MRI)技术与超声心动图技术在诊断女性高原肺动脉高压(PAH)中的价值。

方法

选取2014年4月至2016年10月在青海省心脑血管专科医院收治的76例女性高原PAH患者,并按诊断的方式不同将患者分为MRI组(A组,38例)与心脏超声诊断组(B组,38例),另随机选取50例高原地区健康女性为健康对照组(C组)。A组采用3.0 T MRI诊断,B组采用超声心动图诊断,C组同时接受与A、B组相同的检查操作。观察2种诊断方法对高原PAH患者的诊断准确率,同时对比A、B组患者与C组相关检测结果。3组患者年龄、病程、体质量、身高等一般情况与MRI及超声检测结果采用t检验,诊断效果对比采用χ2检验。

结果

A、B、C组患者年龄、病程、体质量、身高等一般资料比较,差异均无统计学意义(P均>0.05);MRI结果显示A、C组患者右心室前壁、右心室室间隔、右心室舒张末期长径、左心室后壁、肺动脉干内径、左心室收缩末期长径及舒张末期长径比较,差异均有统计学意义(t=10.856、4.962、5.142、4.917、6.426、5.216、7.512,P均<0.05),右心室舒张末期横径、左心房内径、主动脉根部内径、右心室收缩末期横径及左心房内径指标比较,差异均无统计学意义(P均>0.05);同A组患者相比,B组患者的诊断准确率明显较低(94.74% vs 81.58%),差异有统计学意义(χ2=5.801,P<0.01)。同时,B组患者的超声心动图检测表明B组患者的平均收缩期肺动脉压(SPAP)为(44.5±8.6)mmHg(1 mmHg=0.133 kPa),高原PAH女性的右心室功能显著降低,右心室流出道、主肺动脉、右心室内径、右心房内径、右心室前壁厚度、室间隔厚度、左心室心肌功能Tei指数以及右心室射血分数指标与C组比较,差异均有统计学意义(t=10.583、8.965、8.172、10.864、5.056、8.213、4.653及8.672,P均<0.05),而B组患者左心功能正常,左心室射血分数与Tei指数均正常,与C组比较,差异无统计学意义(P均>0.05)。

结论

MRI及超声心动图均可对女性高原PAH患者进行有效诊断,但MRI对女性高原PAH诊断的准确率及价值更高,适合在临床上推广应用。

Objective

To assess the diagnostic value of 3.0T magnetic resonance imaging (MRI) and ultrasonic cardiography in women with high altitude pulmonary arterial hypertension (PAH).

Methods

Seventy-six women with high altitude PAH treated at our hospital were divided into either an MRI group (group A) or an ultrasonic cardiography group (group B), with 38 cases in each group. Fifty healthy women from high altitude areas were enrolled as a control group (group C). Group A underwent MRI examination alone, Group B underwent ultrasonic cardiography examination alone, and Group C underwent concomitant MRI and ultrasonic cardiography examinations. Diagnosis accuracy and diagnostic results were compared among different groups.

Results

Compared with group B, diagnosis accuracy significantly rose in group A (P<0.05). MRI showed that except right ventricular end diastolic transverse diameter, left atrial diameter, aortic diameter, and right ventricular end systolic transverse diameter, other indexes differed significantly between groups A and C (P<0.05). Ultrasonic cardiography showed that the SPAP of group B was (44.5 ± 8.6) mmHg. Right ventricular outflow tract, pulmonary artery, right ventricular inner diameter, right atrial inner diameter, right ventricle anterior wall, interventricular septal thickness, right ventricular Tei index, and right ventricular ejection fraction differed significantly between groups B and C (P<0.05), although there was no significant difference in LVEF or LV-Tei between the two groups (P>0.05).

Conclusion

Both MRI and ultrasonic cardiography can diagnoses high altitude PAH in women effectively. MRI can accurately evaluate the heart structure and function in women with high altitude PAH, representing a more efficient diagnostic method.

表1 3组肺动脉高压患者一般情况对比(±s
表2 A、C组肺动脉高压患者MRI检测结果分析(mm,±s
图1,2 女性高原肺动脉高压患者磁共振成像与超声心动图。图1为右心增大,右心室壁肥厚;图2为肺动脉高压,三尖瓣大量返流
表3 B、C组肺动脉高压患者超声心动图检测结果分析(±s
表4 A组与B组2种诊断肺动脉高压的诊断效果比较[例(%)]
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