中文摘要：

目的通过相位对比（PC）-MRI分析、比较慢性血栓栓塞性肺动脉高压（cTEPH）、特发性肺动脉高压（IPAH）患者近端肺动脉的血流动力学特征。方法前瞻性收集27例肺动脉高压患者资料，包括IPAH患者7例（IPAH组）、CTEPH患者20例（CTEPH组），同时收集20名健康志愿者作为对照组。纳入人群均行PC-MRI检查，采集参数包括主肺和左、右肺动脉，左、右肺叶间动脉的峰值、平均流速和平均流量，肺动脉高压患者行右心漂浮导管测定血流动力学参数。IPAH组、CTEPH组和对照组间测量参数比较采用单因素方差分析。结果CTEPH组、IPAH组及对照组间主肺动脉、左肺动脉、右肺动脉、左肺叶间动脉及右肺叶间动脉的峰值、平均流速及平均流量差异均具有统计学意义（F值为4．13～102．81，P值均〈O．05）。CTEPH组和IPAH组右肺动脉的峰值流速分别为（32．0±7．8）、（50．0±15．O）cm／s，差异具有统计学意义（P〈0．05），其他动脉两组间峰值流速差异均无统计学意义。平均流速两组间差异均无统计学意义。CTEPH组主肺动脉、左肺动脉、右肺动脉、左肺叶间动脉的平均流量分别为（74．3±20．8）、（29．3±12．7）、（43．5±17．4）、（19．2±8．0）ml／s，IPAH组对应动脉的平均流量分别为（61.3±16．7）、（23．2±11．2）、（56．8±13．5）、（12．1±5．8）ml／s，两组间差异均有统计学意义（P值均〈0．05）。结论CTEPH和IPAH患者近端肺动脉血流动力学存在明显不同。3．0 TPC-MRI可以有效地检出和检测肺动脉高压患者近端肺动脉的血流动力学状态。

英文摘要：

Objective To compare the blood flow characteristics of the proximal pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension （CTEPH） and idiopathic pulmonary arterial hypertension （IPAH） by 3.0T PC-MRI. Methods Twenty seven patients with pulmonary arterial hypertension （7 IPAH patients and 20 CTEPH patients） were prospectively included. Twenty healthy volunteers were enrolled as the control group. All subjects underwent PC-MRL PC-MRI derived parameters included peak, mean velocity and mean flow of main pulmonary artery （MPA）, left/right pulmonary artery （LPA/RPA）, left/right interlobar pulmonary artery （LIPA/RIPA）. Right heart catheterization was performed in patients with pulmonary arterial hypertension. The parameters among CTEPH, IPAH group and control group were compared by one way analysis of variance. Results There were significant differences for peak velocity, mean velocity and mean flow among CTEPH, IPAH group and control group （F=4.13-102.81, all P〈0.05）. There was significant difference for peak velocity in RPA between CTEPH[（32.0±7.8）cm/s] and IPAH group[（50.0±15.0）cm/s]. There was no difference for mean velocity between CTEPH and IPAH group. The mean flow between CTEPH and IPAH group was statistically different[MPA： （74.3±20.8） ml/s versus （61.3±16.7） ml/s, LPA： （29.3±12.7） ml/s versus （23.2±11.2） ml/s, RPA： （43.5±17.4） ml/s versus （56.8±13.5） ml/s, LIPA： （19.2 ±8.0） ml/s versus （12.1 ±5.8） ml/s, all P〈0.05]. Conclusion There is significantly different characteristics for the hemodynamics of the proximal pulmonary arteries between CTEPH group and IPAH group. 3.0T PC-MRI may effectively detect the pulmonary hemodynamic changes.