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논문 기본 정보

자료유형
학술저널
저자정보
최규옥 (연세대학교 의과대학 방사선과학교실)
저널정보
대한영상의학회 대한방사선의학회지 대한방사선의학회지 제9권 제1호
발행연도
1973.1
수록면
29 - 42 (14page)

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Mitral stenosis, the most frequent heart disease in adult, showed relatively characteristic pulmonary findings in plain chest X-ray. In recent years the knowledge of the altered physiology of hemodynamics could offer considerable amount of hemodynamic barrier in plain chest. But the value of several parameters was still controversial. In this study a variety of roentgen signs were related to physiologic data and these were acquired by the cardiac catheterization in total of 67 cases of mitral stenosis. 1. Correlation of DPA/DHT ratio (Diameter of pulmonary arterial segment/Diameter of hemithorax$\times$100) to hemodynamic data: The pulmonary arterial segment was dilated by two factors, the one was pulmonary blood flow and the other the blood pressure within it. In mitral stenosis, the cardiac output was decreased to quite uniform level, hence measurement of pulmonary arterial segment might be valuable. The correlation coefficient of DPA/DHT ratio to hemodynamic datas were as follows 0.54 to mean pulmonary artery pressure, 0.32 to pulmonary capillary wedge pressure, -0.37 to mitral valvular area and 0.07 to pulmonary vascular resistence. No significant difference was noted in between pure mitral stenosis and mitral stenosis associated with other valvular disease. 2. Correlation of diameter of right descending pulmonary artery to hemodynamic data: The measurement was made near the first bifurcation of right descending pulmonary artery at its widest point. Pulmonary vascular pattern was best correlated (r=0.71). Another had rough correlation: 0.05 to mean pulmonary artery pressure, 0.31 to pulmonary capillary wedge pressure, -0.44 to mitral valvular area in correlation coefficient. No pulmonary arterial hypertension was observed in the cases diameter of less than 12mm, but all except two cases had pulmonary hypertension in which diameter exceeded 16mm. According to increase of the mean pulmonary arterial pressure, the same increment in pressure increased change pro uced progressively smaller degrees of dilatation of main pulmonary artery and right descending pulmonary artery were enlarged with all degrees of pulmonary arterial segment and right descending pulmonary artery were enlarged with all degrees of pulmonary hypertension and which made enlargement of pulmonary artery as a sign but little value in determining the degrees of pulmonary hypertension. 3. Correlation of pressure of hemosiderosis and intraalveolar edema to hemodynamics: Hemosiderosis was found in 8 cases among 67 cases. No relationship was observed in between the existence of hemosiderosis and the height of pulmonary venous pressure or other hemodynamic factors. Inrraalveolar edema was detected in 7 cases and no significant difference of hemodynamic data was observed whether it is present or not. But the present group all had pulmonary capillary wedge pressure exceeds 19mmHg. 4. Correlation of Kerley's B line to hemodynamic datas: Distinctively present septal line was found in 8 among 65 cases (27.3%): 3 cases in right side, only on case in left side and most of them, 14 cases in both sides. The confirmative factor was not found in distribution of heomdynamic data to the existence itself or detected number of Kerley's B line. But when septal line was found distinctly, pulmonary capillary wedge pressure was all exceeded to 20mmHg except one case. 5. Correlation of pulmonary vascular pattern to hemodynamic data: For the estimation of hemodynamics the above radiographic findings were frequently fraught with overlapping or gave us only limited information. This pulmonary vascular patterns classified in able 1 including peripheral portion as well as central were aimed to compare accordingly with hemodynamic datas. these group showed relative apparent separation in each group especially in mean pulmonary artery pressure: Most of mean pulmonary artery pressure was incluced in the range of below 30 mmHg in group 1, from 25 to 40 mmHg in grou..

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