Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
J Magn Reson Imaging. 2017 Dec;46(6):1551-1572. doi: 10.1002/jmri.25754. Epub 2017 May 8.
At present, most of the cardiac magnetic resonance imaging (MRI) examinations rely on contrast-enhanced protocols, but noncontrast alternatives are emerging. Late gadolinium enhancement (LGE) imaging for the detection of myocardial scar can be considered the main cause for the embedding of cardiac MRI into the clinical routine. The novel noncontrast technique of native T mapping shows promise for tissue characterization in ischemic and nonischemic cardiomyopathy and may provide additional information over conventional LGE imaging. Technical issues, including measurements variability, still need to be resolved to facilitate a wide clinical application. Ischemia detection can be performed with contrast-based stress perfusion and contrast-free stress wall motion imaging. For coronary magnetic resonance angiography (MRA), protocols with and without contrast material have been developed. Research on coronary atherosclerotic plaque characterization has introduced new applications of contrast material. For MRA of the aorta, which traditionally relied on contrast administration, several noncontrast protocols have become available. This review provides an overview of when to use contrast material in cardiac and cardiac-related vascular MRI, summarizes the major imaging building blocks, and describes the diagnostic value of the available contrast-enhanced and noncontrast techniques. Contrast material in cardiac MRI should be used for LGE imaging for tissue characterization in ischemic or nonischemic cardiomyopathy and may be used for stress perfusion imaging for the detection of ischemia. In cardiac-related vascular MRI, use of contrast material should be avoided, unless high-quality angiography is required that cannot be obtained with noncontrast protocols.
5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1551-1572.
目前，大多数心脏磁共振成像（MRI）检查依赖于对比增强方案，但非对比替代方案正在出现。用于检测心肌瘢痕的晚期钆增强（LGE）成像可以被认为是将心脏 MRI 嵌入临床常规的主要原因。新型非对比技术原生 T 映射显示出在缺血性和非缺血性心肌病的组织特征化方面的前景，并可能提供比传统 LGE 成像更多的信息。技术问题，包括测量的可变性，仍需要解决，以促进广泛的临床应用。可以使用基于对比的应激灌注和无对比应激壁运动成像来进行缺血检测。对于冠状动脉磁共振血管造影（MRA），已经开发了有和没有对比剂的方案。对冠状动脉粥样硬化斑块特征的研究引入了对比剂的新应用。对于传统上依赖于对比剂给药的主动脉 MRA，已经有几种非对比方案可用。本综述概述了在心脏和心脏相关血管 MRI 中何时使用对比剂，总结了主要的成像构建块，并描述了现有的对比增强和非对比技术的诊断价值。在心脏 MRI 中，对比剂应用于组织特征化，用于缺血性或非缺血性心肌病的 LGE 成像，并且可用于检测缺血的应激灌注成像。在心脏相关血管 MRI 中，除非需要无法通过非对比方案获得的高质量血管造影，否则应避免使用对比剂。
5 技术功效：第 3 阶段 J. Magn. Reson. Imaging 2017;46:1551-1572。
