基于多学科协作的检查准备在提升心脏磁共振检查效率中的应用研究

An applied study of multidisciplinary team-based examination preparation to enhance cardiac magnetic resonance examination efficiency

摘要

目的 探讨多学科协作的检查准备在心脏磁共振检查中的应用价值，为提升心脏磁共振检查效率提供新思路。方法 医学影像科联合心血管内、外科病房及心血管门诊，制定心脏磁共振检查多学科协作准备方案。采用非同期对照试验，便利抽样选取2024年8月至2025年7月在遵义医科大学附属医院行心脏磁共振检查的132例受检者，分为对照组与试验组各66例。对照组采用常规检查准备，试验组实施多学科协作检查准备。以扫描时间作为主要结局指标，以空约率、检查成功率、重复扫描情况及图像质量评价（采用4分法评价）作为次要结局指标，比较两组检查效率及图像质量。结果 试验组扫描时间（34.68±5.09）min显著短于对照组（43.69±8.77）min（P<0.05），空约率（1.52%）低于对照组（12.12%），检查成功率（96.92%）高于对照组（84.48%），因屏气不佳或晃动所致重复扫描比例更低（P<0.05）；图像质量方面，试验组在心脏结构与心肌首过灌注成像评分中优于对照组（P<0.05），而心功能电影成像与心肌活性延迟强化成像评分组间无显著差异（P>0.05）。结论 在心脏磁共振检查中实施基于多学科协作的检查准备，可有效提升检查效率和图像质量。

Abstract

Objective To evaluate the application value of multidisciplinary team (MDT)-based examination preparations in cardiac magnetic resonance (CMR) examinations and propose new strategies to improve CMR examination efficiency. Methods The department of Medical Imaging, in collaboration with the departments of Cardiology, Cardiovascular Surgery, and Cardiology Outpatient Clinic, established an MDT-based CMR examination preparation protocol. A non-concurrent controlled trial was conducted, recruiting 132 patients via convenience sampling who underwent CMR examinations at the Affiliated Hospital of Zunyi Medical University between August 2024 and July 2025. Participants were assigned to either the control group (n=66), which received standard examination preparation, or the intervention group (n=66), which underwent MDT-based preparation. The primary outcome was scanning time, and the secondary outcomes included the no-show rate, examination success rate, repeat scanning, and image quality assessed on a 4-point scale, in order to compare examination efficiency and image quality between the two groups. Results The scan time in the intervention group (34.68±5.09) min was significantly shorter than that in the control group (43.69±8.77) min. The no-show rate in the intervention group (1.52%) was lower than that in the control group (12.12%), and the examination success rate (96.92%) was higher than that in the control group (84.48%); the differences were statistically significant (P<0.05), and the proportion of patients with repeated scans due to poor breath-holding or patient motion was lower than that in the control group (P<0.05). In terms of image quality, the intervention group scored higher than the control group in cardiac anatomical imaging and first-pass myocardial perfusion imaging (P<0.05), while there were no significant differences between the two groups in cine imaging scores for cardiac function or late gadolinium enhancement imaging scores for myocardial viability (P>0.05). Conclusion MDT-based examination preparation is effective in improving both the efficiency and image quality of CMR examinations.

关键词

多学科协作 / 检查准备 / 心脏磁共振 / 检查效率

Key words

multidisciplinary team / examination preparation / cardiac magnetic resonance / examination efficiency

参考文献

[1] Ensako T, Norikane T, Yamamoto Y, et al. Focal myocardial perfusion abnormalities in cardiac amyloidosis as compared with CMR, bone scintigraphy, and 11C-PiB PET[J]. J Nucl Cardiol, 2021, 28(5): 2408-2411.

[2] Crea F. Cardiac magnetic resonance: challenges, opportunities, and developments[J]. Eur Heart J, 2022, 43(26): 2427-2431.

[3] Ciocca N, Lu H, Tzimas G, et al. Head-to-head comparison and temporal trends of cardiac MRI recommendations in ESC versus ACC/AHA guidelines: a systematic review and meta-analysis[J]. Radiol Cardiothorac Imaging, 2024, 6(3): e230271.

[4] Madl J, Janka R, Bay S, et al. Effects of video-based patient preparation for MRI on clinical processes and patient experience[J]. Eur J Radiol, 2023, 158: 110621.

[5] Eichhorn C, Greulich S, Bucciarelli-Ducci C, et al. Multiparametric cardiovascular magnetic resonance approach in diagnosing, monitoring, and prognostication of myocarditis[J]. JACC Cardiovasc Imaging, 2022, 15(7): 1325-1338.

[6] Nakou E, Patel RK, Fontana M, et al. Cardiovascular magnetic resonance parametric mapping techniques: clinical applications and limitations[J]. Curr Cardiol Rep, 2021, 23(12): 185.

[7] 王妮, 吴琛, 周运锋, 等. 基于压缩感知的心脏磁共振电影成像在左心室应变评估中可行性分析[J]. 磁共振成像, 2024, 15(11): 75-82.

[8] Soon JJY, Juan DWK, Ong WS, et al. Implementation of a multi-disciplinary team and quality of goals of care discussions in palliative surgical oncology patients[J]. Ann Surg Oncol, 2023, 30(13): 8054-8060.

[9] Yang L, Yan C, Wang J. Effect of multi-disciplinary team care program on quality of life, anxiety, and depression in hepatocellular carcinoma patients after surgery: a randomized, controlled study[J]. Front Surg, 2023, 9: 1045003.

[10] 于鹏, 张萌, 张文华, 等. 多学科协作干预方案在早产儿母婴分离产妇中的应用[J]. 中国护理管理, 2025, 25(1): 32-37.

[11] Kramer CM, Barkhausen J, Bucciarelli-Ducci C, et al. Standardized cardiovascular magnetic resonance imaging (CMR) protocols: 2020 update[J]. J Cardiovasc Magn Reson, 2020, 22(1): 17.

[12] Klink V, Muzzarelli S, Lauriers N, et al. Quality assessment of cardiovascular magnetic resonance in the setting of the European CMR registry: description and validation of standardized criteria[J]. J Cardiovasc Magn Reson, 2013, 15(1): 55.

[13] Martin SS, Aday AW, Allen NB, et al. 2025 heart disease and stroke statistics: a report of US and global data from the American Heart Association[J]. Circulation, 2025, 151(8): e41-e660.

[14] 马丽荣, 郭家璇, 李文玲, 等. 4D flow心脏MRI测量左心室血流动力学参数的可靠性[J]. 中国医学影像技术, 2024, 40(2): 221-225.

[15] Westwood M, Almeida AG, Barbato E, et al. Competency-based cardiac imaging for patient-centred care. a statement of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2023, 44(45): 4771-4780.

[16] Addison D, Neilan TG, Barac A, et al. Cardiovascular imaging in contemporary cardio-oncology: a scientific statement from the American Heart Association[J]. Circulation, 2023, 148(16): 1271-1286.

[17] Zhou SP, Wan XC, Wang XD, et al. Investigation and analysis of magnetic resonance imaging experience and psychological status of patients[J]. BMC Psychol, 2024, 12(1): 115.

[18] Zhou Y, Cao Y, Xu S, et al. Randomized controlled trial on the effects of mindfulness-based respiratory decompression therapy in claustrophobic patients undergoing MRI inspection[J]. Front Med (Lausanne), 2023, 10: 1253824.

[19] Wen X, Shi J, Tan W, et al. Effects of aromatherapy and music therapy on patients’ anxiety during MRI examinations: a randomized controlled trial[J]. Eur Radiol, 2023, 33(4): 2510-2518.

[20] 杨旗. 心血管磁共振成像技术检查规范中国专家共识[J]. 中国医学影像技术, 2019, 35(2): 161-169.

[21] Rajiah PS, Sundaram B, Ng MY, et al. Artifacts at cardiac MRI: imaging appearances and solutions[J]. Radiographics, 2025, 45(1): e230200.

[22] Madl JEM, Sturmbauer SC, Janka R, et al. Preparing patients according to their individual coping style improves patient experience of magnetic resonance imaging[J]. J Behav Med, 2022, 45(6): 841-854.

[23] 尹刚, 董文浩, 陈秀玉, 等. 心脏MR压缩感知超快速电影序列评价左右心室收缩功能的应用价值[J]. 中华放射学杂志, 2023, 57(3): 300-305.

[24] 成涛, 陈康, 王远军, 等. 心脏磁共振延迟强化技术进展[J]. 国际医学放射学杂志, 2022, 45(6): 686-689.

基金资助

遵义市科技计划项目(遵市科合HZ字(2024)266)