Abouzeid Christiane M, Shah Tara, Johri Ansh, Weinsaft Jonathan W, Kim Jiwon
Greenberg Cardiology Division/Department of Medicine, Weill Medical College of Cornell University, 525 East 68th Street, Starr-4, New York, NY, 10021, USA.
Curr Treat Options Cardiovasc Med. 2017 Sep 25;19(11):82. doi: 10.1007/s11936-017-0584-9.
Right ventricular (RV) structure and function is clinically important in a wide range of conditions. While conventional echocardiography (echo) methods are widely used, its limitations in RV assessment due its complex geometry are well recognized. New applications of traditional echo methods as well as emerging echo techniques including 3-dimensional (3D) echo and speckle tracking strain have the potential to overcome limitations of conventional echo, though widespread clinical use remains to be seen. Volumetric methods using cardiac magnetic resonance (CMR) and computed tomography (CT) provide accurate assessment of RV function without geometric assumptions. In addition, tissue characterization imaging for myocardial scar and fat using CMR and CT provides important information regarding the RV beyond structure and function alone and has clinical applications for diagnosis and prognosis in a broad range of pathologies. Limitations also exist for these two advanced modalities including availability and patient suitability for CMR and need for contrast and radiation exposure for CT. The complementary role of each modality for the RV as well as emerging evidence for the use of each imaging method in diagnosis and management of RV pathologies is outlined in this study.
右心室(RV)的结构和功能在多种病症中具有重要的临床意义。虽然传统超声心动图(echo)方法被广泛应用,但其由于右心室复杂的几何形状而在评估中存在的局限性已得到充分认识。传统echo方法的新应用以及包括三维(3D)echo和斑点追踪应变在内的新兴echo技术有潜力克服传统echo的局限性,不过其在临床的广泛应用仍有待观察。使用心脏磁共振成像(CMR)和计算机断层扫描(CT)的容积测量方法可在不做几何假设的情况下准确评估右心室功能。此外,利用CMR和CT对心肌瘢痕和脂肪进行组织特征成像,不仅能提供有关右心室结构和功能之外的重要信息,还在广泛的病理学诊断和预后方面具有临床应用价值。这两种先进的检查方式也存在局限性,包括CMR的可用性和患者适用性,以及CT需要使用造影剂和存在辐射暴露问题。本研究概述了每种检查方式对右心室的互补作用,以及每种成像方法在右心室疾病诊断和管理中的新证据。