Androulakis Emmanuel, Swoboda Peter P
St George's University Hospitals NHS Foundation Trust, London, UK.
Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
Curr Treat Options Cardiovasc Med. 2018 Aug 31;20(10):86. doi: 10.1007/s11936-018-0679-y.
Cardiovascular magnetic resonance (CMR) is frequently used in the investigation of suspected cardiac disease in athletes. In this review, we discuss how CMR can be used in athletes with suspected cardiomyopathy with particular reference to volumetric analysis and tissue characterization. We also discuss the finding of non-ischaemic fibrosis in athletes describing its prevalence, distribution and clinical importance.
The strengths of CMR include high spatial resolution, unrestricted imaging planes and lack of ionizing radiation. Regular physical exercise leads to cardiac remodeling that in certain situations can be clinically challenging to differentiate from various cardiomyopathies. Thorough morphological assessment by CMR is fundamental to ensuring accurate diagnosis. Developments in tissue characterization by late gadolinium enhancement and T1 mapping have the potential to be powerful additional tools in this challenging clinical situation. Using late gadolinium enhancement, it is also possible to detect non-ischaemic fibrosis in athletes who do not have overt cardiomyopathy. The mechanisms of this fibrosis are unclear; however, it does appear to be clinically important. We also review data on the prevalence of non-ischaemic fibrosis in athletes. CMR is a powerful tool to aid in the diagnosis of cardiomyopathy in athletes. It may also have a future role in assessing fibrosis related to long-term participation in sport.
心血管磁共振成像（CMR）常用于对疑似患有心脏病的运动员进行检查。在本综述中，我们讨论CMR如何用于疑似心肌病的运动员，尤其涉及容积分析和组织特征描述。我们还讨论了在运动员中发现的非缺血性纤维化，描述其患病率、分布及临床重要性。
CMR的优势包括高空间分辨率、不受限制的成像平面以及无电离辐射。经常进行体育锻炼会导致心脏重塑，在某些情况下，临床上很难将其与各种心肌病区分开来。CMR进行全面的形态学评估是确保准确诊断的基础。通过延迟钆增强和T1映射进行组织特征描述的进展，有可能成为应对这一具有挑战性临床情况的有力辅助工具。使用延迟钆增强，还可以在没有明显心肌病的运动员中检测到非缺血性纤维化。这种纤维化的机制尚不清楚；然而，它在临床上似乎很重要。我们还回顾了关于运动员中非缺血性纤维化患病率的数据。CMR是辅助诊断运动员心肌病的有力工具。它在评估与长期参与运动相关的纤维化方面可能也有未来的作用。
