Nelson Katarina H, Li Tao, Afonso Luis
Department of Internal Medicine, Division of Cardiology, Wayne State University, Harper University Hospital, 3990 John R., Detroit, MI 48201, USA.
Cardiol Rev. 2009 Jan-Feb;17(1):24-30. doi: 10.1097/CRD.0b013e318184b383.
The diagnosis of acute myocarditis can be challenging, primarily because of the clinical diversity at presentation, the nonspecificity of traditional noninvasive tests, as well as the poor diagnostic yield and potential complications inherent with endomyocardial biopsy. Contrast-enhanced and nonenhanced cardiac magnetic resonance imaging (MRI) is emerging as an imaging modality of choice to diagnose and monitor the progression of myocarditis. MRI is nonionizing, non-nephrotoxic, and in comparison to coronary angiography, allows the clinician to rapidly eliminate irreversible ischemic injury (acute coronary syndrome) from the differential diagnosis. This timely review discusses the advantages and limitations of cardiac MRI over alternative diagnostic modalities and offers a practical approach to the contemporary diagnosis and assessment of acute myocarditis.
急性心肌炎的诊断可能具有挑战性，主要原因在于其临床表现的多样性、传统非侵入性检查的非特异性，以及心内膜心肌活检固有的诊断阳性率低和潜在并发症。对比增强和非增强心脏磁共振成像（MRI）正成为诊断和监测心肌炎进展的首选成像方式。MRI是非电离的、无肾毒性的，与冠状动脉造影相比，能让临床医生在鉴别诊断中迅速排除不可逆性缺血性损伤（急性冠状动脉综合征）。这篇及时的综述讨论了心脏MRI相对于其他诊断方式的优势和局限性，并提供了一种当代急性心肌炎诊断和评估的实用方法。
