Impact of papillary muscles in ventricular volume and ejection fraction assessment by cardiovascular magnetic resonance
Impact of papillary muscles in ventricular volume and ejection fraction assessment by cardiovascular magnetic resonance
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DOI：
10.1081/jcmr-120027800
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发表时间：
2004-01-01
影响因子：
6.4
通讯作者：
Trappe, HJ
中科院分区：
文献类型：
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作者：
Sievers, B;Kirchberg, S;Trappe, HJ
心血管磁共振(CMR)是确定右、左室容量和射血分数的准确工具。然而，目前的标准短轴技术是耗时的，因此在日常使用中往往不可行，因为必须标记乳头肌和小梁，并从总脑室容量中减去它们的体积。为了减少计算时间，我们评估了包括乳头肌和小梁体积在内的体积数据，并将结果与标准技术的结果进行了比较。采用德国西门子Magnetom公司的TrueFISP机对30例患者(17例正常人，13例冠心病患者)进行了CMR检查。使用标准短轴技术计算右、左室容量和射血分数，然后在不减去乳头和小梁体积的情况下再次计算。两种方法的比较是通过测定心室容量和射血分数结果的差异来进行的。两种方法测得的右、左室每搏输出量、收缩末期容量、左室舒张末期容量差异有统计学意义(P<0.011)。右室舒张末容量(p>；0.149)或左、右室射血分数(p>；0.130)无显著差异。除左心室EDV的情况外，方法1和方法2的结果偏差不随心脏病的存在或不存在而显著变化。改良法的测量速度比标准短轴测量法快得多(25±4分钟比13±3分钟，p=0.000)。虽然在不减去乳头状骨和小梁体积的情况下发现了系统性差异，但这些差异很小，对健康受试者或冠心病患者可能没有临床意义。不减去这些结构的体积，可以更快地确定右、左室容量和射血分数，而不会损失与标准短缩技术相关的准确性。
Cardiovascular magnetic resonance (CMR) is an accurate tool for the determination of right and left ventricular volumes and ejection fractions. However, the current standard short-axis technique is time-consuming and thus, often not practicable for routine daily use, because papillary muscles and trabeculations have to be marked and their volumes subtracted from the total ventricular volume. To reduce calculation time we evaluated the volumetric data that included papillary muscle and trabecular volumes and compared the outcome with the results of the standard technique. Thirty patients (17 healthy, 13 with coronary heart disease) were examined by CMR using TrueFISP (Magnetom, Siemens, Erlangen, Germany). Right and left ventricular volumes and ejection fractions were calculated using the standard short-axis technique and then again without subtracting papillary and trabecular volumes. The two methods were compared by determining the differences in results for ventricular volumes and ejection fractions. Statistically significant differences were found between the two methods for right and left ventricular stroke volumes and end-systolic volumes, and left ventricular end-diastolic volumes (EDV) (p less than or equal to 0.011). No significant difference was found for right ventricular end-diastolic volumes (p>0.149) or left or right ventricular ejection fraction (p>0.130). Except in the case of left ventricular EDV, the deviations in the results of method 1 and method 2 did not vary significantly with the presence or absence of heart disease. Measurements were obtained considerably more quickly with the modified method than with the standard short-axis method (25+/-4 min vs. 13+/-3 min, p=0.000). Although systematic differences were found when papillary and trabecular volumes were not subtracted, these differences are small and may not be of clinical relevance in healthy subjects or patients with coronary heart disease. Not subtracting the volumes of these structures enables faster determination of right and left ventricular volumes and ejection fractions without loss of the accuracy associated with the standard shortaxis technique.