Pierce Theodore, Hovnanian Meline, Hedgire Sandeep, Ghoshhajra Brian
Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Founders 216, Boston, MA, 02114, USA.
Department of Cardiothoracic Radiology, Mount Sinai School of Medicine - BISLR, 1000 Tenth Avenue, New York, NY, 10019, USA.
Curr Treat Options Cardiovasc Med. 2017 Nov 14;19(12):94. doi: 10.1007/s11936-017-0593-8.
Cardiovascular disease is an important cause of morbidity and mortality during pregnancy and the postpartum period. During pregnancy, the cardiovascular system undergoes extensive hemodynamic, hormonal, and microstructural changes which may exacerbate a preexisting underlying cardiovascular condition or predispose to cardiovascular complications not typically seen in young healthy women. Such conditions include spontaneous coronary artery dissection, atherosclerotic coronary artery disease, and peripartum cardiomyopathy. When evaluating this patient population, the diagnostic strategy should be tailored to specifically assess this distinct disease spectrum. The choice of imaging techniques must also consider potential risks to both the mother and child; a unique challenge of diagnostic imaging during pregnancy. The risk of radiation from radiography, computed tomography, and nuclear medicine imaging; iodinated and gadolinium-based contrast media for computed tomography and magnetic resonance imaging respectively; and heat deposition from sonography are of special importance during pregnancy. A thorough understanding of pregnancy-specific cardiovascular complications and the capabilities and risks of available diagnostic imaging modalities is crucial to appropriately manage the pregnant patient.
心血管疾病是妊娠和产后发病及死亡的重要原因。在孕期，心血管系统会经历广泛的血流动力学、激素和微观结构变化，这些变化可能会使已有的潜在心血管疾病恶化，或导致年轻健康女性中通常不会出现的心血管并发症。这些疾病包括自发性冠状动脉夹层、动脉粥样硬化性冠状动脉疾病和围产期心肌病。在评估这一患者群体时，诊断策略应进行调整，以专门评估这一独特的疾病谱。成像技术的选择还必须考虑对母婴的潜在风险；这是孕期诊断成像的一个独特挑战。孕期，来自X线摄影、计算机断层扫描和核医学成像的辐射风险；计算机断层扫描和磁共振成像分别使用的碘化造影剂和钆基造影剂；以及超声检查产生的热沉积尤为重要。全面了解孕期特有的心血管并发症以及现有诊断成像方式的能力和风险，对于妥善处理孕妇至关重要。
