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Koroner Arter Hastalığı Olan Olgularda Kardiyak Manyetik Rezonans Görüntüleme ile Sol Ventrikül Fonksiyonlarının Değerlendirilmesi

Yıl 2008, Cilt: 5 Sayı: 1, 22 - 27, 01.04.2008

Öz

Amaç: Koroner arter hastalığı kalbin duvar hareketlerini ve fonksiyonlarını etkilemektedir. Günümüzde kalp fonksiyonları genellikle ekokardiyografi ile değerlendirilmektedir. Bu çalışmada sol ventrikül duvar hareket kusurlarının ve ejeksiyon fraksiyonunun EF değerlendirilmesinde Kardiyak Manyetik Rezonans Görüntüleme KMRG ’nin duyarlılığı araştırılmıştır. Gereç ve Yöntem: Çalışmamızda koroner arter hastalığı saptanan ve ekokardiyografik incelemeleri yapılmış 30 hasta ile 20 sağlıklı olguda K-MRG görüntülenmesi yapıldı. Kısa aks, 4 boşluk ve 2 boşluk görüntüler alındıktan sonra sine K-MRG görüntüler, retrospektif ve EKG tetiklemeli olarak parelel görüntüleme tekniği eşliğinde bir kalp siklusunda ortalama 20 görüntü alabilen True-FISP sekansı ile alındı. Görüntüler sol ventrikül EF ve duvar hareketleri değerlendirmesi için ARGUS programına aktarıldı. K-MRG ve ekokardiyografi sonuçları istatistiksel olarak Student’s-t paired testi ve Pearson korelasyon analizi ile karşılaştırıldı Bulgular: Tüm olgularda K-MRG incelemeleri 20–25 dakika içerisinde başarı ile gerçekleştirildi. Yapılan karşılaştırmalarda kontrol grubunda EF açısından istatistiksel bir fark saptanmadı p>0.05 . Hasta grubunda yapılan karşılaştırılmalarda hem EF değerleri, hem de duvar hareketlerinin skorlanmasında ortalama değerler arasında istatistiksel fark p

Kaynakça

  • Jan R, Geuns V, Baks T, et al. Automatic quantitative left ventricular analysis of cine MR images by using three- dimensional information for contour detection. Radiology 2006; 240:215–221. 2. Lombardi M, Bartolozzi C. MRI of the heart and vessels. 1.th. ed. Milan, Springer, 2004:145–166.
  • Bellenger NG, Marcus N, Davies LC, et al. Left ventricular function and mass after morthotopic heart transplantation: a comparison of cardiovascular magnetic resonance with echocardiography. J Heart Lung Transplant 2000; 19:444–452.
  • Teichholz LE, Kreulen T, Herman MV, et al. Problems in echcardiographic volume determinations
  • echocardiographicangiographic
  • correlations in the presence or absence of asynergy. Am J Cardiol 1976; 37:7–11.
  • Higgins CB. Prediction of myocardial viability by MRI. Circulation 1999; 99:727–729.
  • Jorn JW. Sandstede assessment of myocardial viability by MR Imaging. Eur Radiol 2003; 13:52–61.
  • The multicenter postinfarction research group. Risk stratification and survival after myocardial infarction. N Engl J Med 1983; 309:331–336.
  • Lewis SJ, Sawada SG, Ryan T, et al. Segmental wall motion abnormalities in the absence of clinically documented myocardial infarction: clinical significans and evidence of hibernating myocardium. Am Heart J 1991; 121:1088–1094.
  • Teichholz LE, Kreulen T, Herman MV, et al. Problems in echocardiographic volume determinations: angiographic correlations in the presence or absence of asynergy. Am J Cardiol 1976; 37:7–11.
  • Nikolay PN, Constantin C, Loh PH, et generation al. echocardiography for left ventricular volumetric and functional measurements: comparison resonance. Eur J Echocardiography 2006; 7:365–372. 3-Dimensional with cardiac magnetic 11. Nachtomy E, Cooperstein R, Vaturi M, et al. Automatic assessment of cardiac function from short-axis MRI: procedure and Resonance , Issue, Pages 365–376.
  • Magnetic Imaging, Volume 12. Germain P, Roul G, Kastler B, et al. Inter-study variability in left ventricular mass measurement. Comparison between M-mode echography and MRI. Eur Heart J 1992; 13:1011–1019.
  • Constantine G, Shan K, Flamm SD. Role of MRI. Clinical Cardiology. Lancet 2004; 363:2162–2171.
  • Moon, J.C. Lorenz, C.H., Francis, J.M., et al. Breath-hold FLASH and FISP cardiovascular ventricular volume differences and reproducibility. Radiology 2002; 223:789- 797. imaging: left 15.
  • Plein S, Bloomer TN, Ridgway JP, et al. Steady-state free precession magnetic resonance comparison with segmented k-space gradient-echo imaging. J Magn Reson Imaging 2001; 14:230–236. the heart: 16. Utz JA, Herfkens RJ, Heinsimer JA, et al. Cine MR determination of left ventricular ejection fraction. AJR Am J Roentgenol 1987; 148:839–843.
  • Semelka RC, Tomei E, Wagner S, et al. Normal left ventricular dimensions and function: interstudy reproducibility of measurements with cine-MR imaging. Radiology 1990;174:763. 18. Mogelvang J, Stokholm
  • KH, Saunamaki K, et al. Assessment of left ventricular resonance radionuclide angiography and echocardiography. Eur Heart J 1992; 13: 1677–83.
  • contrast 19. Bellenger NG, Burgess MI, Ray SG, et al. Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, ventriculography magnetic resonance. European Heart Journal 2000; 21:1387–1396.
  • Malm S, Frigstad S, Sagberg E, et al. Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography: a comparison with magnetic resonance imaging. J Am Coll Cardiol 2004; 44:1030–1035. 21. Abraham TP, Nishimura RA. Myocardial strain: can we fnally measure contractility? J Am Coll Cardiol 2001; 37:731-734

The Evaluation Of The Left Ventricular Movement İn The Case Of Coronary Arterial Diseases With Cardiac Magnetic Resonance İmaging

Yıl 2008, Cilt: 5 Sayı: 1, 22 - 27, 01.04.2008

Öz

Purpose: In case of coronary artery disease CAD , cardiac wall movements and output functions are being affected. Cardiac funtions are generally evaluated with echocardiography nowadays. In this study, the effectiveness of cardiac magnetic resonance imaging C-MRI in the left ventricular wall movement abnormality and ejection fraction EF has been evaluated and compared with echocardiography. Materials and Methods: In our study, 30 patients with CAD and 20 cases as control group were examined with echocardiography and C-MRI within the same day. After obtaining short axis, 4 chamber and 2 chamber morphologic images, cine C-MRI was taken with True-FISP sequence using parellel images and retrospective ECG triggered technique which has capability of 20 images in one cardiac cycle. After transferring the images to workstation, left ventricular EF and wall movements were evaluated using ARGUS programme which is dedicated to cardiac functions. The results of C-MRI and echocardiography were statistically compared with Students-t paired test and Pearson correlation analysis. Results: All of the C-MRI examinations were performed succesfully within 20-25 minutes. There were no statistical difference in comparison of the EF between echocardiography and C-MRI in control group. But in the patient group, the average value of the EF and wall movement scores were statistically different from each other P

Kaynakça

  • Jan R, Geuns V, Baks T, et al. Automatic quantitative left ventricular analysis of cine MR images by using three- dimensional information for contour detection. Radiology 2006; 240:215–221. 2. Lombardi M, Bartolozzi C. MRI of the heart and vessels. 1.th. ed. Milan, Springer, 2004:145–166.
  • Bellenger NG, Marcus N, Davies LC, et al. Left ventricular function and mass after morthotopic heart transplantation: a comparison of cardiovascular magnetic resonance with echocardiography. J Heart Lung Transplant 2000; 19:444–452.
  • Teichholz LE, Kreulen T, Herman MV, et al. Problems in echcardiographic volume determinations
  • echocardiographicangiographic
  • correlations in the presence or absence of asynergy. Am J Cardiol 1976; 37:7–11.
  • Higgins CB. Prediction of myocardial viability by MRI. Circulation 1999; 99:727–729.
  • Jorn JW. Sandstede assessment of myocardial viability by MR Imaging. Eur Radiol 2003; 13:52–61.
  • The multicenter postinfarction research group. Risk stratification and survival after myocardial infarction. N Engl J Med 1983; 309:331–336.
  • Lewis SJ, Sawada SG, Ryan T, et al. Segmental wall motion abnormalities in the absence of clinically documented myocardial infarction: clinical significans and evidence of hibernating myocardium. Am Heart J 1991; 121:1088–1094.
  • Teichholz LE, Kreulen T, Herman MV, et al. Problems in echocardiographic volume determinations: angiographic correlations in the presence or absence of asynergy. Am J Cardiol 1976; 37:7–11.
  • Nikolay PN, Constantin C, Loh PH, et generation al. echocardiography for left ventricular volumetric and functional measurements: comparison resonance. Eur J Echocardiography 2006; 7:365–372. 3-Dimensional with cardiac magnetic 11. Nachtomy E, Cooperstein R, Vaturi M, et al. Automatic assessment of cardiac function from short-axis MRI: procedure and Resonance , Issue, Pages 365–376.
  • Magnetic Imaging, Volume 12. Germain P, Roul G, Kastler B, et al. Inter-study variability in left ventricular mass measurement. Comparison between M-mode echography and MRI. Eur Heart J 1992; 13:1011–1019.
  • Constantine G, Shan K, Flamm SD. Role of MRI. Clinical Cardiology. Lancet 2004; 363:2162–2171.
  • Moon, J.C. Lorenz, C.H., Francis, J.M., et al. Breath-hold FLASH and FISP cardiovascular ventricular volume differences and reproducibility. Radiology 2002; 223:789- 797. imaging: left 15.
  • Plein S, Bloomer TN, Ridgway JP, et al. Steady-state free precession magnetic resonance comparison with segmented k-space gradient-echo imaging. J Magn Reson Imaging 2001; 14:230–236. the heart: 16. Utz JA, Herfkens RJ, Heinsimer JA, et al. Cine MR determination of left ventricular ejection fraction. AJR Am J Roentgenol 1987; 148:839–843.
  • Semelka RC, Tomei E, Wagner S, et al. Normal left ventricular dimensions and function: interstudy reproducibility of measurements with cine-MR imaging. Radiology 1990;174:763. 18. Mogelvang J, Stokholm
  • KH, Saunamaki K, et al. Assessment of left ventricular resonance radionuclide angiography and echocardiography. Eur Heart J 1992; 13: 1677–83.
  • contrast 19. Bellenger NG, Burgess MI, Ray SG, et al. Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, ventriculography magnetic resonance. European Heart Journal 2000; 21:1387–1396.
  • Malm S, Frigstad S, Sagberg E, et al. Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography: a comparison with magnetic resonance imaging. J Am Coll Cardiol 2004; 44:1030–1035. 21. Abraham TP, Nishimura RA. Myocardial strain: can we fnally measure contractility? J Am Coll Cardiol 2001; 37:731-734
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Nihat Taşdemir¹ Bu kişi benim

Halil Arslan¹ Bu kişi benim

Serhat Avcu¹ Bu kişi benim

Mustafa Tuncer³ Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2008
Yayımlandığı Sayı Yıl 2008 Cilt: 5 Sayı: 1

Kaynak Göster

Vancouver Taşdemir¹ N, Arslan¹ H, Avcu¹ S, Tuncer³ M. Koroner Arter Hastalığı Olan Olgularda Kardiyak Manyetik Rezonans Görüntüleme ile Sol Ventrikül Fonksiyonlarının Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2008;5(1):22-7.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty