【摘要】 目的 定量测量法洛四联症(TOF)根治术后患者右心室纤维化程度,探讨TOF术后右心室纤维化程度与患者右心功能、手术时间及随访时间的相关性。方法 回顾性纳入本院64例TOF根治术后并接受增强MRI检查的患者(男38例,女26例),利用3.0T MRI分析评价右心室舒张末期容积、右心室射血分数及延迟强化率(LGE率)等参数。采用t检验(或U检验)进行对比分析。结果 64例TOF患者术后均出现右心室增大,且显示右心室流出道延迟强化;其中39例(60.9%)伴有术后肺动脉瓣重度返流,13例(20.3%)因为肺动脉瓣严重返流或者残留左向右分流畸形而施行二次手术。与右心室LGE率<50%的患者比较,右心室LGE率≥50%的患者呈现更长的手术年龄及随访时间,且右心室射血分数更低;相比心功能正常组,心功能不全组的LGE率更大。结论 3.0T MRI-LGE技术可用于定量检测TOF术后心肌纤维化程度,同时测量心功能相关参数,辅助临床干预及评价患者术后远期效果。更多还原

【Abstract】 Objective To quantitatively detect myocardial fibrosis of right ventricle in repaired tetralogy of Fallot(TOF) patients,and to investigate the correlation between the degree of right ventricular fibrosis with right heart function,repaired time and follow-up period in TOF patients.Methods 64 repaired TOF patients with 3.0T MRI images were retrospectively reviewed(male 38 cases,female 26cases).The right ventricular end diastolic volume,right ventricular ejection fraction and late gadolinium enhancement rate(LGE rate) were analyzed and evaluated by 3.0T MRI.The differences between continuous variables were analyzed with t test(or U test).Results All 64 repaired TOF patients had enlarged right ventricular and showed a marked LGE in the right ventricular outflow tract;most of the patients(39 cases,60.9%) were associated with severe postoperative pulmonary valve regurgitation.Because of severe pulmonary valve regurgitation or residual left to right shunting,13 cases(20.3 %) underwent second operation.Compared with the group with <50% right ventricular LGE rate,the group with≥50% right ventricular LGE rate had longer follow-up period,later repaired time and lower right ventricular ejection fraction.The LGE rate in the cardiac dysfunction group was greater than that in the normal cardiac function group.Conclusion 3.0T MRI-LGE technology can be used to quantitatively detect the degree of myocardial fibrosis and measure the cardiac function related parameters in repaired TOF patients,which might asvsist in the clinical intervention and evaluate the long-term postoperative effect.更多还原