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Objective To explore the clinical application value of left atrial function with feature tracking cardiac magnetic resonance imaging (FT-CMR) by evaluating preliminarily left atrial strain and strain rate in patients with atrial fibrillation. Methods Thirty patients with paroxysmal atrial fibrillation, thirty patients with persistent atrial fibrillation and twenty-two healthy subjects were enrolled. All the subjects underwent cardiac magnetic resonance imaging with the real steady-state free precession(SSFP) sequence. FT-CMR parameters included left atrial strain and strain rate parameters, left atrial volume and function parameters were detected by using offline cardiovascular analysis software, respectively. Left atrial strain and strain rate parameters included left atrial total strain(Εs), passive strain(Εe), active strain(Εa), peak positive strain rate(SRs), peak early negative strain rate(SRe)and peak late negative strain rate(SRa). Volume and function parameters included maximum of left atrial volume(LAVmax), minimum of left atrial volume(LAVmin), total left atrial emptying fraction(LATEF), passive left atrial emptying fraction(LAPEF)and active left atrial emptying fraction(LAAEF). The differences in the general data among the paroxysmal atrial fibrillation group, the persistent atrial fibrillation group and the control group were compared by usingχ2 test or ANOVA analysis. The differences in all parameters between the atrial fibrillation group and the control group, the paroxysmal atrial fibrillation group and the persistent atrial fibrillation group were compared by using independent t test. Left atrial strain and strain rate parameters on an intra-observer and inter-observer were determined by intraclass correlation coefficient(ICC)analyses. Results Compared to control group, LAVmax and LAVmin in atrial fibrillation group were significantly increased(t=9.737,7.889,P<0.001);The LATEF and LAPEF had no significant difference, the LAAEF in two groups had statistically significant difference(t=-4.762,P<0.001).The absolute value of Es, Ee, Ea, SRs, SRe, SRa in atrial fibrillation group were significantly reduced than in control group(t=-7.732,-6.610,-6.493,-7.546, 6.864, 5.917,P<0.001). Compared with paroxysmal atrial fibrillation group, LAVmax and LAVmin in persistent atrial fibrillation group were increased obviously, LATEF and LAPEF were significantly decreased, and the differences were statistically significant(t=-4.575,-5.524, 4.002, 4.028,P<0.001).The LAAEF in two groups had no statistically significant difference. Compared with strain and strain rate in two groups, absolute value of Es, Ee, Ea, SRs, SRe, SRa in persistent atrial fibrillation group significantly decreased than in paroxysmal atrial fibrillation(t=4.310, 3.128, 4.465, 5.496,-3.290,-3.863,P<0.001). The intra-group and inter-group had well correlation coefficients between the observers in the left atrial strain and strain rate parameters of the subjects(ICC=0.85—0.94,0.81—0.90). Conclusions FT-CMR technique can be used to assess the left atrial strain and strain rate in patients with atrial fibrillation;Left atrial reservoir, conduit and booster-pump functions in patients with atrial fibrillation were impaired. Patients with persistent atrial fibrillation had worse left atrial function throughout the entire cardiac cycle compared with those with paroxysmal atrial fibrillation.
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Objective To evaluate the value of CTA in assessing congenital heart disease and related heterotaxy syndrome.Methods A total of 20 patients with congenital heart disease and heterotexy syndrome underwent CTA and 3-dimensional reconstructions.And intracardiac and extracardiac abnormalities were assessed.Results Three cases were left isomerism,two of which were bi-lobed left lungs and trilobed right lungs,and another one was bi-lobed lungs.The most common associated cardiovascular anomalies included single ventricle (n=2),atrial septal defect (n=2),ventricular septal defect (n=1),transposition of the great arteries (n=2),pulmonary artery stenosis (n=2),atresia (n=1),persistent left superior vena (n=1),no hepatic segment of inferior vena cava (n=1).The rest 17 cases were right isomerism.All of them were trilobed lungs.Associated cardiovascular anomalies included single ventricle (n=9),double outlet of right ventricle (n=2),endocardial cushion defect (n=6),atrial septal defect (n=10),patent foramen ovale (n=1),ventricular septal defect (n =8),transposition of the great arteries (n =14),pulmonary artery stenosis (n =16),atresia (n =1),pulmonary venous drainage (n=6),persistent left superior vena (n=7),no hepatic segment of inferior vena cava (n=2).Conclusion CTA can clearly show the structure of heart,great vessels,chest and abdomen which is a useful tool to accurately assess congenital heart disease and related heterotaxy syndrome for medical or surgical management.
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Objective To assess the value of magnetic resonance (MR) imaging (MRI) in depicting the depth of myometrial infiltration, cervical invasion and lymph nodes metastasis in patients with endometrial carcinoma compared with surgicopathologic findings. Methods Thirty-eight patients with endometrial carcinoma diagnosed by pathology were inspected by MRI in this prospective study. MR images were analyzed by two radiologists to report the depth of myometrial infiltration, infiltration of the uterine cervix and lymph nodes metastasis. MRI and surgicopathologic staging of endometrial carcinoma were based on FICO classification. MRI findings were compared with surgicopathologic findings. Results The overall accuracy rate of MRI in staging endometrial carcinoma was 77.1 %. The results of Kappa statistics showed that there was strong consistency between MRI and surgicopathology for staging of endometrial carcinoma (k= 0.677). Respective diagnostic accuracy, sensitivity, specificity, negative and positive predictive values in assessing myometrial infiltration(>l/2 depth) were 91.4 %, 83.3 %, 95.6 %, 91.7 % and 90.9 %; those in cervical infiltration were 94.2 %, 80.0 %, 96.7 %, 96.7 %, and 80.0 %; and those in lymph node assessment were 96.2 %, 66.7 %, 100 %, 95.8 % and 100 %. Conclusion MRI is highly accurate in depicting the depth of myometrial infiltration, cervical invasion, lymph nodes metastasis and local-regional staging of endometrial carcinoma.