Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty Berlin and the Max-Delbrueck Center for Molecular Medicine, and HELIOS Klinikum Berlin-Buch, Berlin 13125, Germany.
Eur Heart J Cardiovasc Imaging. 2013 Jan;14(1):62-8. doi: 10.1093/ehjci/jes125. Epub 2012 Jun 26.
Awareness of cardiovascular magnetic resonance (CMR) is growing due to increasing evidence for providing relevant functional and morphologic information. This single-centre survey aimed at providing descriptive data about the clinical application and potential impact of CMR.
All 2598 clinically indicated CMR exams were prospectively registered during 1 year in one single centre. Detailed data of the individual patient and procedural information of each exam were collected. In a simulation of CMR-based clinical decision-making in a subgroup of 250 cases, the influence of CMR on further diagnostic testing and answering the clinical question was estimated. Inflammatory (31%) and coronary (28%) heart disease were the most frequent indications. The exams were fast (98% < 60 min), robust (0.4% non-diagnostic image quality), and mostly used contrast media (76%). Anxiolytic sedation was required to overcome claustrophobia in 3.8%. Two per cent of all exams were terminated prematurely. No severe adverse events occurred. All moderate adverse events (0.5%) were associated with stress medication (1.7% of all stress tests) or contrast media (0.15% of all contrast enhanced studies). In the simulation, CMR influenced the individual selection of diagnostic testing and provided valuable information to establish or exclude a diagnosis.
This single-centre experience demonstrated a versatile application of CMR at reasonable time expense, safety, and robustness. The simulation of CMR-based decision-making indicated that CMR may influence patient management.
由于越来越多的证据表明心血管磁共振（CMR）可以提供相关的功能和形态信息，因此人们对 CMR 的认识不断提高。本单中心研究旨在提供关于 CMR 临床应用和潜在影响的描述性数据。
在一个中心，前瞻性地对 1 年内的 2598 例临床指征的 CMR 检查进行了注册。收集了每位患者的详细数据和每个检查的程序信息。在对 250 例患者的亚组进行 CMR 临床决策模拟中，估计了 CMR 对进一步诊断测试和回答临床问题的影响。炎症性（31%）和冠状动脉（28%）心脏病是最常见的适应症。检查快速（98%<60 分钟）、稳健（0.4%非诊断性图像质量），且大部分使用对比剂（76%）。为克服幽闭恐惧症，3.8%需要使用抗焦虑镇静剂。有 2%的检查提前终止。未发生严重不良事件。所有中度不良事件（0.5%）均与应激药物（所有应激试验的 1.7%）或对比剂（所有增强对比研究的 0.15%）有关。在模拟中，CMR 影响了诊断测试的个体选择，并提供了有价值的信息来建立或排除诊断。
本单中心经验表明，CMR 在合理的时间、费用、安全性和稳健性方面具有广泛的应用。基于 CMR 的决策模拟表明，CMR 可能会影响患者的管理。
