Department of Internal Medicine and Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
Department of Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
J Cardiovasc Magn Reson. 2017 Oct 9;19(1):75. doi: 10.1186/s12968-017-0389-8.
Parametric mapping techniques provide a non-invasive tool for quantifying tissue alterations in myocardial disease in those eligible for cardiovascular magnetic resonance (CMR). Parametric mapping with CMR now permits the routine spatial visualization and quantification of changes in myocardial composition based on changes in T1, T2, and T2*(star) relaxation times and extracellular volume (ECV). These changes include specific disease pathways related to mainly intracellular disturbances of the cardiomyocyte (e.g., iron overload, or glycosphingolipid accumulation in Anderson-Fabry disease); extracellular disturbances in the myocardial interstitium (e.g., myocardial fibrosis or cardiac amyloidosis from accumulation of collagen or amyloid proteins, respectively); or both (myocardial edema with increased intracellular and/or extracellular water). Parametric mapping promises improvements in patient care through advances in quantitative diagnostics, inter- and intra-patient comparability, and relatedly improvements in treatment. There is a multitude of technical approaches and potential applications. This document provides a summary of the existing evidence for the clinical value of parametric mapping in the heart as of mid 2017, and gives recommendations for practical use in different clinical scenarios for scientists, clinicians, and CMR manufacturers.
参数图技术为那些适合心血管磁共振(CMR)的患者提供了一种非侵入性的工具,用于量化心肌疾病中的组织改变。CMR 的参数图现在允许根据 T1、T2 和 T2*(星)弛豫时间和细胞外容积(ECV)的变化,常规地可视化和量化心肌成分的变化。这些变化包括与主要的心肌细胞内紊乱相关的特定疾病途径(例如,铁过载或安德森-法布里病中的糖脂积累);心肌间质中的细胞外紊乱(例如,心肌纤维化或心脏淀粉样变性,分别来自胶原或淀粉样蛋白的积累);或两者兼而有之(细胞内和/或细胞外水增加的心肌水肿)。参数图通过定量诊断、患者间和患者内的可比性的提高以及相关的治疗改善,有望改善患者的护理。有多种技术方法和潜在的应用。本文件总结了截至 2017 年年中,参数图在心脏中的临床价值的现有证据,并为科学家、临床医生和 CMR 制造商在不同的临床情况下的实际使用提供了建议。