Noninvasive quantification of left-to-right shunt by phase contrast magnetic resonance imaging in secundum atrial septal defect: the effects of breath holding and comparison with invasive oximetry
Noninvasive quantification of left-to-right shunt by phase contrast magnetic resonance imaging in secundum atrial septal defect: the effects of breath holding and comparison with invasive oximetry
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相衬磁共振成像对继发孔房间隔缺损左向右分流的无创定量：屏气的影响以及与有创血氧测定法的比较
DOI：
10.1007/s10554-018-1297-1
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Honda Hiroshi
中科院分区：
文献类型：
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作者：
Yamasaki Yuzo;Kawanami Satoshi;Kamitani Takeshi;Sagiyama Koji;Sakamoto Ichiro;Hiasa Ken-ichi;Yabuuchi Hidetake;Nagao Michinobu;Honda Hiroshi
目的探讨屏气对继发孔型房间隔缺损(ASD)患者左向右分流的影响。连续35例继发孔型房间隔缺损患者接受了右心导管术和有创血氧饱和度测定。对主肺动脉和升主动脉进行相位对比磁共振成像(MRI)。所有测量是在自由呼吸(FB)(安静呼吸；不屏气)、呼气屏气(EBH)和吸气屏气(IBH)时获得的。肺循环流量(Qp)和体循环流量(Qs)由心率乘以每搏输出量计算。比较FB、EBH和IBH期间的测量结果，并评估与有创血氧饱和度测量的差异。QP在Fb、EBH、IBH三个时间点间差异有统计学意义(Fb，7.70 ± 2.68；EBH，7.18 ± 2.34；IBH，6.88 ± 2.51；L/分钟)，而Qs无显著差异(Fb，3.44 ± 0.74；EBH，3.40 ± 0.83；IBH，3.40 ± 0.86；L/分钟)。QP/Qs在FB、EBH、IBH三组间差异有统计学意义(FB，2.38 ± 1.12；EBH，2.24 ± 0.95；IBH，2.14 ± 0.97)。FB和EBH的QP/Qs与有创血氧饱和度测量的QP/Qs的相关性好于IBH。EBH的符合限度小于FB和IBH。继发孔型房间隔缺损患者屏气后Qp/Qs显著降低。EBH时MRI测量QP/Qs的准确性高于有创血氧饱和度测定仪。
To investigate the effect of breath-holding on left-to-right shunts in patients with a secundum atrial septal defect (ASD). Thirty-five consecutive patients with secundum ASDs underwent right heart catheterization and invasive oximetry. Phase-contrast magnetic resonance imaging (MRI) was performed for the main pulmonary artery and ascending aorta. All measurements were obtained during free breathing (FB) (quiet breathing; no breath-hold), expiratory breath-hold (EBH), and inspiratory breath-hold (IBH). Pulmonary circulation flow (Qp) and systemic circulation flow (Qs) were calculated by multiplying the heart rate by the stroke volume. Measurements during FB, EBH, and IBH were compared, and the differences compared to invasive oximetry were evaluated. There were significant differences among the measurements during FB, EBH, and IBH for Qp (FB, 7.70 ± 2.68; EBH, 7.18 ± 2.34; IBH, 6.88 ± 2.51 l/min); however, no significant difference was found for Qs (FB, 3.44 ± 0.74; EBH, 3.40 ± 0.83; IBH, 3.40 ± 0.86 l/min). There were significant differences among the measurements during FB, EBH, and IBH for Qp/Qs (FB, 2.38 ± 1.12; EBH, 2.24 ± 0.95; IBH, 2.14 ± 0.97). Qp/Qs during FB and EBH correlated better with Qp/Qs measured by invasive oximetry than did IBH. The limit of agreement was smaller for EBH than for FB and IBH. In patients with secundum ASDs, Qp/Qs significantly decreased with breath-holding. The accuracy of the Qp/Qs measurement by MRI compared with invasive oximetry during EBH was higher than during FB and IBH.