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  • 杨映霞,汪芳,尹刚,赵世华,陆敏杰.基于心脏磁共振特征追踪技术的中国正常人左心房功能的定量研究[J].第二军医大学学报,2019,40(3):250-256    [点击复制]
  • YANG Ying-xia,WANG Fang,YIN Gang,ZHAO Shi-hua,LU Min-jie.Left atrial function in healthy Chinese population by cardiac magnetic resonance-feature tracking imaging: a quantitative study[J].Acad J Sec Mil Med Univ,2019,40(3):250-256   [点击复制]
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基于心脏磁共振特征追踪技术的中国正常人左心房功能的定量研究
杨映霞1,2,汪芳3,尹刚1,赵世华1,陆敏杰1*
0
(1. 国家心血管病中心、中国医学科学院阜外医院磁共振影像科, 北京 100037;
2. 广西壮族自治区人民医院放射科, 南宁 530021;
3. 宁夏回族自治区人民医院放射科, 银川 750000
*通信作者)
摘要:
目的使用心脏磁共振特征追踪(CMR-FT)技术定量评价中国正常人的左心房功能。方法按纳入标准入选磁共振检查结果显示正常的健康人。采用半傅里叶单次激发技术及平衡稳态自由进动序列获得标准心脏各长轴及短轴切面及电影序列,由2名医师独立测量左心房功能参数,包括左心房容积、射血分数、应变及应变率等。男性与女性相对应参数的比较采用两独立样本t检验。不同年龄组间相应参数的比较采用单因素方差分析。结果共纳入63名研究对象,男34名、女29名,≤29岁19名、30~44岁23名、≥45岁21名。左心房各径线:左心房前后径为(26.1±4.5)mm,左右径为(54.8±5.9)mm;左心房储存功能参数:总射血分数为(63.5±6.9)%,总应变为(45.9±11.7)%,总应变率为(1.5±0.5)s-1;导管功能参数:被动射血分数为(24.6±9.1)%,被动应变为(22.2±8.1)%,被动应变率为(-0.8±0.3)s-1;泵血功能参数:主动射血分数为(51.3±8.9)%,主动应变为(23.7±9.2)%,主动应变率为(-1.3±0.5)s-1。除体表面积、左心房各径线及最大容积、主动收缩前容积在男女之间差异有统计学意义(P均<0.05)之外,其余左心房各功能参数性别间差异均无统计学意义(P均>0.05)。不同年龄组间左心房导管功能差异有统计学意义(P<0.05),而储存及泵血功能差异无统计学意义。相关性分析结果显示左心房总射血分数与总应变、被动射血分数与被动应变、主动射血分数与主动应变均呈正相关(r=0.77、0.74、0.77,P均<0.01)。左心房功能各参数组内相关系数均>0.6,Bland-Altman分析显示2名医师间具有较好的一致性。结论 CMR-FT技术因其高度的可重复性可用于获得中国正常人左心房功能的相关参数。
关键词:  左心房功能  磁共振成像  心脏磁共振特征追踪  健康人
DOI:10.16781/j.0258-879x.2019.03.0250
投稿时间:2018-10-29修订日期:2018-12-14
基金项目:国家自然科学基金(81571647,81370036,81620108015,81771811),北京市自然科学基金(7152124),首都临床特色项目基金(Z151100004015141).
Left atrial function in healthy Chinese population by cardiac magnetic resonance-feature tracking imaging: a quantitative study
YANG Ying-xia1,2,WANG Fang3,YIN Gang1,ZHAO Shi-hua1,LU Min-jie1*
(1. Department of Magnetic Resonance Imaging, National Center for Cardiovascular Diseases and Fuwai Hospital of Chinese Academy of Medical Sciences, Beijing 100037, China;
2. Department of Radiology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China;
3. Department of Radiology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750000, Ningxia Hui Autonomous Region, China
*Corresponding author)
Abstract:
Objective To quantitatively evaluate the left atrial function in healthy Chinese population by cardiac magnetic resonance-feature tracking (CMR-FT). Methods Healthy individuals with normal magnetic resonance examination results were enrolled according to the inclusion criteria. Cardiac long- and short-axis images and cine were obtained using semi-Fourier single-shot technique and balanced steady-state free precession sequence. The left atrial function parameters, including left atrial volume, ejection fraction, strain and strain rate, were measured by 2 independent observers. Two independent sample t test was used to compare the parameters between males and females. One-way analysis of variance was performed to compare the parameters among different age groups. Results A total of 63 volunteers were included in this study. Of 63 volunteers, 34 were males and 29 females; and 19 volunteers were aged ≤ 29 years, 23 were aged 30-44 years and 21 were aged ≥ 45 years. The anteroposterior diameter of left atrium was (26.1±4.5) mm, and the transverse diameter was (54.8±5.9) mm. The total ejection fraction of left atrium was (63.5±6.9)%, total strain was (45.9±11.7)%, and total strain rate was (1.5±0.5) s-1. The passive ejection fraction of left atrium was (24.6±9.1)%, passive strain was (22.2±8.1)%, and passive strain rate was (-0.8±0.3) s-1. The active ejection fraction of left atrium was (51.3±8.9)%, active strain was (23.7±9.2)%, and active strain rate was (-1.3±0.5) s-1. There were significant differences in the body surface area, the left atrial diameters, maximal volume and pre-active contraction volume between the males and the females (all P<0.05), while the differences in the other left atrial function parameters were not significant (all P>0.05). There were significant differences in the left atrial conduit function among the different age groups (all P<0.05), while there were no significant differences in reservior or booster pump function parameters. Correlation analysis showed that there were positive correlations between total ejection fraction and total strain, passive ejection fraction and passive strain, and active ejection fraction and active strain (r=0.77, 0.74 and 0.77; all P<0.01). The correlation coefficients of all left atrial function parameters were all >0.6, and the Bland-Altman analysis showed better consistency between the two observers. Conclusion CMR-FT can be used to obtain parameters related to left atrial function in healthy Chinese population due to its high repeatability.
Key words:  left atrial function  magnetic resonance imaging  cardiac magnetic resonance-feature tracking  healthy