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建立心脏磁共振成像项目:问题、陷阱与期望。

Establishing a cardiac MRI program: problems, pitfalls, expectations.

作者信息

Atalay Michael K

机构信息

Rhode Island Hospital, Providence, RI 02903, USA.

出版信息

J Am Coll Radiol. 2005 Sep;2(9):740-8. doi: 10.1016/j.jacr.2005.02.002.

Abstract

Magnetic resonance imaging (MRI) has been used to evaluate the cardiovascular system for almost 2 decades. Although vascular applications have been robust and steadily improving for many years, the utility of MRI for clinical cardiac imaging has been limited. However, recent advances in hardware technology and pulse sequence design have led to substantial improvements in image quality, while reducing scan times to clinically reasonable durations. Pulse sequences using electrocardiographic gating and k-space segmentation have made it possible to obtain high-contrast, high-resolution images of the beating heart within single breath-holds. These images in turn have provided unprecedented visualization of myocardial morphology and function. Because of these developments, cardiac MRI (CMR) has made rapid and dramatic inroads into the clinical arena. Currently, the primary limitations to routine clinical application are hardware availability, clinical acceptance, politics, examination cost, and not least of all physician education. As these limitations are overcome or made more manageable, the clinical use of CMR will grow, potentially without bound. Combined with steady hardware development and an ever-growing armamentarium of pulse sequences, MRI may ultimately become the modality of choice for cardiac imaging. Because cardiac imaging is relatively unknown territory for most radiologists and because the high-end equipment has until now been sparsely available, CMR has been largely limited to major medical centers. However, if sufficient interest is present and resources are appropriately allocated, CMR can be successfully implemented in community imaging practices.

摘要

磁共振成像(MRI)用于评估心血管系统已有近20年。尽管血管成像应用多年来一直蓬勃发展且不断进步,但MRI在临床心脏成像方面的效用一直有限。然而,硬件技术和脉冲序列设计的最新进展已使图像质量大幅提高,同时将扫描时间缩短至临床可接受的时长。采用心电图门控和k空间分段的脉冲序列使得在单次屏气期间就能获得跳动心脏的高对比度、高分辨率图像。这些图像进而提供了心肌形态和功能前所未有的可视化效果。由于这些进展,心脏磁共振成像(CMR)已迅速且显著地进入临床领域。目前,常规临床应用的主要限制包括硬件可用性、临床接受度、政策、检查成本,尤其是医师培训。随着这些限制被克服或更易于管理,CMR的临床应用将会增加,甚至可能无限制增长。结合硬件的持续发展和不断增加的脉冲序列,MRI最终可能成为心脏成像的首选方式。由于大多数放射科医生对心脏成像相对陌生,且高端设备目前供应稀少,CMR在很大程度上限于大型医疗中心。然而,如果有足够的兴趣并适当分配资源,CMR可以在社区成像机构中成功开展。

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