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心血管磁共振成像在淀粉样变性中的应用:现状。

Cardiovascular magnetic resonance imaging for amyloidosis: The state-of-the-art.

机构信息

Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China.

William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London, UK.

出版信息

Trends Cardiovasc Med. 2019 Feb;29(2):83-94. doi: 10.1016/j.tcm.2018.06.011. Epub 2018 Jun 28.

Abstract

Amyloidosis results from insoluble precursor proteins being deposited in the extracellular compartment. The prognosis of the disease is predominantly determined by cardiac involvement due to amyloid accumulation that contributes to cardiac dysfunction and disturbed conduction of cardiac electrical signals. The clinical and radiological manifestations of amyloidosis are often non-specific, making amyloidosis a diagnostic challenge both for clinicians and radiologists. Cardiovascular magnetic resonance imaging, including conventional sequences, late gadolinium enhancement, T1 mapping and determination of extracellular volume fraction is a multi-dimensional modality for the assessment and diagnosis of cardiac amyloidosis and, in addition, is an excellent tool for risk stratification and disease tracking.

摘要

淀粉样变性是由不溶性前体蛋白在细胞外间隙沉积引起的。该疾病的预后主要取决于心脏受累情况,淀粉样物质的蓄积会导致心脏功能障碍和心脏电信号传导紊乱。淀粉样变性的临床表现和影像学表现往往不具有特异性,这使得淀粉样变性无论是对临床医生还是放射科医生来说,都是一个诊断上的挑战。心血管磁共振成像,包括常规序列、钆延迟增强、T1 mapping 和细胞外容积分数的测定,是评估和诊断心脏淀粉样变性的多维手段,此外,也是进行风险分层和疾病跟踪的绝佳工具。

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