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| 肺动脉高压患者右心功能CMR成像指标与2D-STI检测参数的相关性分析 |
| 戴欣,魏淼,刘晓莹,王惠秋,张文 |
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| (重庆市公共卫生医疗救治中心医学影像科;重庆医科大学附属第一医院放射科) |
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| 摘要: |
| 目的：探究心脏磁共振成像(CMR)指标与二维斑点追踪成像(2D-STI)技术测量右室游离壁纵向应变(RVLSrw)在评估肺动脉高压(PH)患者预后的作用。方法：回顾性分析本院2018年1月至2020年1月收治的经右心导管确诊且资料完整的77例PH患者的临床资料,另选77例健康志愿者作为对照组,所有入选者均经2D-STI技术及CMR检查,使用2D-STI技术测量患者右室游离壁纵向应变(RVLSrw)、右心房储备功能(RASr)、右心房管道功能(RASc)和右心房泵功能(RASp),使用CMR检查患者右心室指标,包括射血分数(EF)、舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)、每搏输出量指数(SVI)、心指数(CI)、心肌质量(MM)、心肌质量指数(MMI),分析测量参数之间的相关性病绘制ROC曲线检测其诊断效能。结果：①CMR成像结果显示,PH组EF、SVI、CI、MM、MMI水平低于对照组,EDVI、ESVI高于对照组,EF、EDVI、ESVI组间差异有统计学意义(P<0.05)；②2D-STI技术检测结果显示,PH组RVLSrw、RASr、RASp指标高于对照组,RASc低于对照组,RVLSrw、RASr、RASc的组间差异具有统计学意义(P<0.05)；③person相关性结果显示,EF与RVFLS(r=0.517)、RASr(r=0.523)、RASc(0.272)相关性显著,EDVI与RVLSrw(r=0.526)、RASr(r=0.306)相关性显著,ESVI与RVLSrw(r=0.601)、RASr(r=0.597)、RASc(r=0.281)相关性显著,(P<0.05)；④ROC曲线分析结果显示,EF、EDVI、ESVI、RVLSrw、RASr、RASc检测患者AUC依次为0.756、0.739、0.820、0.725、0.957、0.659,敏感度依次为49.4%、48.1%、66.2%、92.2%、92.2%、100.0%,特异度依次为100.0%、100.0%、100.0%、49.4%、88.3%、33.8%。结论：2D-STI技术检测各参数与CMR成像参数之间相关性显著,RVLSrw对于评估PH患者预后作用较好。 |
| 关键词: 心脏磁共振成像 二维斑点追踪成像 右室游离壁纵向应变 肺动脉高压 |
| DOI： |
| 投稿时间：2020-09-11修订日期：2020-09-16 |
| 基金项目: |
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| The role of CMR imaging indicators and 2D-STI technology measuring the longitudinal strain of the free wall of the right ventricle in assessing the prognosis of patients with PH |
| dai xin,wei miao,liu xiaoying,wang huiqiu,zhang wen |
| (Chongqing Public Health Medical Center) |
| Abstract: |
| Objective：To explore the role of cardiac magnetic resonance imaging (CMR) indicators and two-dimensional speckle tracking imaging (2D-STI) technology to measure the longitudinal strain of the right ventricular free wall (RVLSrw) in evaluating the prognosis of patients with pulmonary hypertension (PH).Methods：To retrospectively analyze the clinical data of 77 patients with PH who were diagnosed by right heart catheterization and complete the data in our hospital from January 2018 to January 2020. Another 77 healthy volunteers were selected as the control group. All the selected patients received 2D -STI technology and CMR examination, using 2D-STI technology to measure the longitudinal strain of the right ventricular free wall (RVLSrw), right atrial reserve function (RASr), right atrial duct function (RASc) and right atrial pump function (RASp), using CMR Check the patient’s right ventricular indicators, including ejection fraction (EF), end diastolic volume index (EDVI), end systolic volume index (ESVI), stroke volume index (SVI), heart index (CI), myocardial mass (MM) , Myocardial mass index (MMI), analyze the correlation between measured parameters and draw ROC curve to detect its diagnostic efficacy.Result：①CMR imaging results showed that the levels of EF, SVI, CI, MM, and MMI in the PH group were lower than those in the control group, and EDVI and ESVI were higher than those in the control group. The difference between EF, EDVI and ESVI groups was statistically significant (P<0.05); ②2D- STI technology test results showed that the indexes of RVLSrw, RASr, and RASp of PH group were higher than those of control group, and RASc was lower than that of control group. The difference between groups of RVLSrw, RASr and RASc was statistically significant (P<0.05); ③person correlation results showed that, EF has significant correlation with RFLLS (r=0.517), RASR (r=0.523), RASc (0.272), EDVI has significant correlation with RVLSrw (r=0.526), RASr (r=0.306), ESVI and RVLSrw (r=0.601) ), RASr (r=0.597), RASc (r=0.281) were significantly correlated (P<0.05); ④ROC curve analysis results showed that the AUC of patients detected by EF, EDVI, ESVI, RVLSrw, RASr, and RASc were 0.756 and 0.739 respectively , 0.820, 0.725, 0.957, 0.659, the sensitivity is 49.4%, 48.1%, 66.2%, 92.2%, 92.2%, 100.0%, and the specificity is 100.0%, 100.0%, 100.0%, 49.4%, 88.3%, 33.8%.Conclusion:The 2D-STI technology detects significant correlations between the parameters and CMR imaging parameters, and RVLSrw has a better effect on the prognosis of PH patients. |
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