本文選題：磁共振成像　切入點(diǎn)：相位對(duì)比　出處：《寧夏醫(yī)科大學(xué)》2014年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的 探討MRI相位對(duì)比血流測(cè)量（PC-MRI）技術(shù)對(duì)健康成年人主肺動(dòng)脈(MPA)結(jié)構(gòu)及血流動(dòng)力學(xué)測(cè)量的準(zhǔn)確性及應(yīng)用價(jià)值以及利用公式估測(cè)肺動(dòng)脈平均壓（MPAP）的可行性。 方法 采用3.0T PC-MRI測(cè)量20例健康志愿者M(jìn)PA直徑，面積，峰值流速及一個(gè)心動(dòng)周期的平均血流量，利用公式計(jì)算MPA相對(duì)擴(kuò)展度、返流分?jǐn)?shù)及MPAP。48小時(shí)內(nèi)對(duì)同一健康志愿者采用TTE測(cè)量MPA直徑及正向峰值流速，利用公式計(jì)算MPA面積，一個(gè)心動(dòng)周期的平均血流量、相對(duì)擴(kuò)展度及MPAP。并將PC-MRI估測(cè)的MPAP及TTE估測(cè)的MPAP分別與右心導(dǎo)管薈萃報(bào)道的MPAP進(jìn)行比較。 結(jié)果 1.PC-MRI測(cè)量的20例健康成年人MPA最大直徑為（26.70±2.11）mm，最小直徑為（21.23±3.16）mm，最大面積為（5.14±0.99）cm2，最小面積為（3.55±1.01）cm2，正向峰值流速為（72.59±11.58）cm/s，反向峰值流速為（19.69±8.89）cm/s，，平均流量為（61.80±13.63）ml/beat，平均正向流量為（64.71±14.90）ml/beat，平均反向流量為（3.07±2.32）ml/beat，計(jì)算的相對(duì)擴(kuò)展度為（49.08±20.55）%，反流分?jǐn)?shù)為（4.54±2.98）%，MPAP為（14.08±2.95）mmHg；TTE測(cè)量的20例健康成年人主肺動(dòng)脈最大直徑為（22.34±1.71）mm，最小直徑為（18.61±1.67）mm，正向峰值流速為（81.47±8.78）cm/s，計(jì)算的最大面積為（3.94±0.62）cm2，最小面積為（2.74±0.48）cm2，相對(duì)擴(kuò)展度為（45.66±19.91）%，平均流量為（65.17±13.88）ml/beat，MPAP為（6.70±12.89）mmHg。 2.PC-MRI與TTE測(cè)量的MPA最大直徑、最小直徑、最大面積、最小面積、正向峰值流速及平均流量均存在明顯差異（P均＜0.05）,但MPA相對(duì)擴(kuò)展度在兩種方法之間差異無(wú)統(tǒng)計(jì)學(xué)意義（P=0.609）。 3.PC-MRI估測(cè)MPAP與右心導(dǎo)管薈萃報(bào)道的平均、男性、女性、＜30歲、30～50歲及＞50歲健康成年人的MPAP差異無(wú)統(tǒng)計(jì)學(xué)意義（分別為P=0.8602，P=0.7611，P=0.7668，P=0.4460，P=0.5514，P=0.3839）。 4.以右心導(dǎo)管薈萃報(bào)道的平均MPAP為金標(biāo)準(zhǔn),PC-MRI估測(cè)的20例健康志愿者M(jìn)PAP100%位于右心導(dǎo)管測(cè)量95%可信區(qū)間內(nèi)，無(wú)負(fù)值出現(xiàn)；而TTE估測(cè)的MPAP僅有45%位于右心導(dǎo)管測(cè)量95%可信區(qū)間內(nèi)，且有6例（30%）出現(xiàn)負(fù)值。 結(jié)論 1.PC-MRI可以準(zhǔn)確測(cè)量健康成年人MPA血管大小、彈性及血流動(dòng)力學(xué)參數(shù)，為心血管疾病提供正常參考。 2.利用公式PC-MRI可以準(zhǔn)確估測(cè)健康成年人的MPAP，為MRI估測(cè)MPAP提供了新方法。 3.由于呼吸狀態(tài)的不同，PC-MRI與TTE測(cè)量的血流動(dòng)力學(xué)參數(shù)存在差異，可能不適用于對(duì)比研究。 4.PC-MRI公式估測(cè)的健康成年人MPAP準(zhǔn)確性明顯優(yōu)于TTE，有望替代TTE成為篩查PH的新方法。
[Abstract]:Purpose. To investigate the accuracy and application value of MRI phase contrast flow measurement (PC-MRI) in measuring the structure and hemodynamics of MPAs in healthy adults, and the feasibility of using the formula to estimate the mean pulmonary artery pressure (MPAP). Method. The diameter, area, peak velocity and mean blood flow of MPA were measured by 3.0T PC-MRI in 20 healthy volunteers. The relative expansion of MPA was calculated by the formula. TTE was used to measure the diameter and forward peak velocity of MPA in the same healthy volunteers within MPAP.48 hour. The area of MPA and the mean blood flow in a cardiac cycle were calculated by the formula. The relative extensibility and MPAP. the MPAP and MPAP estimated by PC-MRI and TTE were compared with MPAP reported by right cardiac catheterization respectively. Results. 1. The maximum diameter of MPA measured by PC-MRI in 20 healthy adults was 26.70 鹵2.11 mm, the minimum diameter was 21.23 鹵3.16 mm, the maximum area was 5.14 鹵0.99 cm ~ 2, the minimum area was 3.55 鹵1.01 cm ~ (-2), the forward peak velocity was 72.59 鹵11.58 cm / s, the reverse peak velocity was 19.69 鹵8.89 cm / s, the average flow rate was 61.80 鹵13.63 ml / L / s, the average positive flow rate was 64.71 鹵14.90 ml / beat. The flow rate is 3.07 鹵2.32 ml / L 路L 路beat, the calculated relative expansion is 49.08 鹵20.55, the reflux fraction is 4.54 鹵2.98 mm, the maximum diameter of pulmonary artery is 22.34 鹵1.71 mm, the minimum diameter is 18.61 鹵1.67 mm, the forward peak velocity is 81.47 鹵8.78 cm / s, the maximum area is 3.94 鹵0.62cm ~ (2), and the minimum area is 3.94 鹵0.62 mm 路cm ~ (-2), the minimum diameter is 18.61 鹵1.67 mm, the forward peak velocity is 81.47 鹵8.78 cm / s, and the maximum calculated area is 3.94 鹵0.62 mm 路cm ~ (-2), the minimum area is 1.71 mm, the minimum diameter is 18.61 鹵1.67 mm, and the forward peak velocity is 81.47 鹵8.78 cm / s, respectively. The average flow rate was 65.17 鹵13.88ml / ml / m ~ (-1), and the mean MPAP was 6.70 鹵12.89mm / h / g. The relative extensibility was 45.66 鹵19.91 mm 路cm ~ (2), and the mean flow rate was 65.17 鹵13.88 ml / m ~ (-1) 路min ~ (-1) 路m ~ (-2). 2. The maximum diameter, minimum diameter, maximum area, minimum area, forward peak velocity and average flow rate of MPA measured by PC-MRI and TTE were all significantly different (P < 0.05), but there was no significant difference in MPA relative expansion between the two methods. 3. PC-MRI estimated that there was no significant difference in MPAP between MPAP and right cardiac catheterization in average, male, female, < 30 years old, 30 years old and over 50 years old healthy adults (P = 0.8602, P 0.7611, P 0.7668, P = 0.4460, P = 0.5514, P 0.3839, respectively). 4. Using the average MPAP reported by right cardiac catheterization as the gold standard, MPAP100% of 20 healthy volunteers were located within the 95% confidence interval of right cardiac catheterization without negative value, while the MPAP estimated by TTE was only 45% in 95% confidence interval of right cardiac catheterization. There were negative values in 6 cases (30%). Conclusion. 1. PC-MRI can accurately measure the vascular size, elasticity and hemodynamic parameters of MPA in healthy adults, and provide a normal reference for cardiovascular diseases. 2. The formula PC-MRI can accurately estimate the MPAPs of healthy adults, which provides a new method for estimating MPAP by MRI. 3. The difference of hemodynamic parameters measured by PC-MRI and TTE may not be suitable for comparative study. 4. The accuracy of PC-MRI formula in estimating MPAP in healthy adults is better than that in healthy adults. It is expected that PC-MRI formula will replace TTE as a new method for screening PH.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R540.45;R445.2;R544.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 雷曉燕;郭佑民;許貴平;陳敏;李潤(rùn)民;楊健;;中心肺動(dòng)脈血流速度的MRI測(cè)量研究[J];中國(guó)醫(yī)學(xué)影像技術(shù);2006年03期

本文編號(hào)：1621206