ESTIMATION OF RIGHT VENTRICULAR MASS IN NORMAL SUBJECTS AND IN PATIENTS WITH PRIMARY PULMONARY-HYPERTENSION BY NUCLEAR-MAGNETIC-RESONANCE IMAGING
ESTIMATION OF RIGHT VENTRICULAR MASS IN NORMAL SUBJECTS AND IN PATIENTS WITH PRIMARY PULMONARY-HYPERTENSION BY NUCLEAR-MAGNETIC-RESONANCE IMAGING
复制标题
DOI：
10.1016/0735-1097(93)90327-w
复制
发表时间：
1993-05-01
影响因子：
24
通讯作者：
BARST, RJ
中科院分区：
文献类型：
--
作者：
KATZ, J;WHANG, J;BARST, RJ
目标.本研究旨在检测核磁共振（NMR）成像作为一种无创性技术在正常人和原发性肺动脉高压患者中估测右心室质量的准确性。一个准确的手段，无创估计右心室质量可能会允许更好地表征程度的右侧压力或容量超负荷所造成的潜在的心脏或肺部疾病。对13例原发性肺动脉高压患者和10例正常志愿者进行了心脏舒张末期短轴心电图（ECG）门控自旋回波核磁共振成像。通过将跨越心肌的所有切片上的心肌切片体积相加并乘以心肌密度来计算右心室和左心室质量。通过对10个小牛心脏进行成像，并将核磁共振测定的左右心肌质量与通过称量左右心室重量测定的实际质量进行比较，验证了心肌质量测定技术。在小牛心脏研究中，右心室和左心室直接测量的心室质量与NMR计算的质量之间具有良好的相关性。原发性肺动脉高压患者的右心室质量指数高于正常人（62.69 ± 8.72 g/m2 vs. 23.32 ± 1.36 g/m2，p <0.0005）。两组左室重量指数无显著性差异。心肌质量测定的平均观察者内和观察者间变异性均较低。右室重量指数与平均肺动脉压呈直线相关（r = 0.75，p <0.003）。心电图门控自旋回波核磁共振成像的心脏可用于定量右心室质量在正常受试者和原发性肺动脉高压患者，在其中，它也可以提供一种替代的非侵入性技术估计平均肺动脉压。
Objectives. This study was designed to test the accuracy of nuclear magnetic resonance (NMR) imaging as a noninvasive technique for estimating right ventricular mass in normal subjects and in patients with primary pulmonary hypertension.Background. An accurate means of noninvasively estimating right ventricular mass may allow better characterization of the degree of right-sided pressure or volume overload caused by underlying cardiac or pulmonary diseases.Methods. End-diastolic short-axis electrocardiogram (ECG)-gated spin echo NMR images of the heart were obtained in vivo in 13 patients with primary pulmonary hypertension and 10 normal adult volunteers. Both right and left ventricular mass were computed by summing the myocardial slice volumes over all slices spanning the myocardium and multiplying by myocardial density. This technique of myocardial mass determination was verified by imaging 10 calf hearts and comparing the NMR-determined right and left myocardial mass with the actual mass determined by weighing the right and left ventricles.Results. In the calf heart study, an excellent correlation was obtained between the directly measured ventricular mass and the NMR-calculated mass, for both the right and the left ventricle. Patients with primary pulmonary hypertension had an elevated right ventricular mass index compared with that of normal subjects (62.69 +/- 8.72 g/m2 vs. 23.32 +/- 1.36 g/m2, p < 0.0005). There was no significant difference in left ventricular mass index between the two groups. Both mean intraobserver and inter-observer variability in myocardial mass determination were low. Linear regression analysis between right ventricular mass index and mean pulmonary artery pressure was significant (r = 0.75, p < 0.003).Conclusions. Electrocardiogram-gated spin echo NMR imaging of the heart may be used for quantitating right ventricular mass in normal subjects and in patients with primary pulmonary hypertension, in whom it may also provide an alternative noninvasive technique for estimating mean pulmonary artery pressure.