【摘要】 肺动脉高压(PAH)是一种以肺血管重构和右心衰竭为主要特征的疾病。右心室(RV)功能评估对PAH患者的预后判断和治疗决策至关重要。近年来，多模态影像技术的快速发展为右心功能评估提供了新的工具。三维超声心动图(3DE)通过容积成像克服了传统二维超声的几何假设限制，可准确测量右心室容积和射血分数。斑点追踪超声心动图(STE)通过分析心肌应变参数[如右室游离壁纵向应变(RVFWLS)]实现了对亚临床右心功能障碍的早期识别。心脏磁共振(CMR)不仅能精确评估右心结构和功能，还能提供组织特征信息。放射性核素血管造影(RNA)可无创定量评估RV射血分数及容积参数，同时，RV-肺动脉耦联(RV-PA)的无创评估指标如TAPSE/PASP、RVFWLS/PASP等具有重要的预后价值。虽然各种影像技术各有优势和局限，但多模态联合应用可显著提高对右心功能评估的准确性。未来研究应致力于标准化测量方法、优化图像分析算法，并探索人工智能在多模态数据整合中的应用，为PAH患者的精准诊疗提供更可靠的影像学依据。更多还原

【Abstract】 Pulmonary arterial hypertension(PAH) is a disease characterized by pulmonary vascular remodeling and right heart failure. The assessment of right ventricular(RV) function is crucial for prognostic evaluation and treatment decision-making in PAH patients. In recent years, the rapid development of multimodal imaging techniques has provided new tools for RV functional assessment. Three-dimensional echocardiography(3DE) overcomes the geometric assumptions of traditional two-dimensional echocardiography through volumetric imaging, enabling accurate measurement of RV volumes and ejection fraction. Speckle-tracking echocardiography(STE) allows early identification of subclinical RV dysfunction by analyzing myocardial strain parameters, such as RV free wall longitudinal strain(RVFWLS). Cardiac magnetic resonance(CMR) not only precisely evaluates RV structure and function but also provides tissue characterization. Radionuclide angiography(RNA) can noninvasively quantify RV ejection fraction and volumetric parameters. Additionally, noninvasive indicators of RV-pulmonary artery(RV-PA) coupling, such as TAPSE/PASP and RVFWLS/PASP, hold significant prognostic value. Although each imaging modality has its own advantages and limitations, the combined application of multimodal techniques can significantly improve the accuracy of RV functional assessment. Future research should focus on standardizing measurement methods, optimizing image analysis algorithms, and exploring the application of artificial intelligence in multimodal data integration to provide more reliable imaging-based evidence for the precise diagnosis and treatment of PAH patients.更多还原