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心脏磁共振成像(CMR)在心肌病诊断中的作用:一项系统评价。

The role of cardiac magnetic resonance (CMR) in the diagnosis of cardiomyopathy: A systematic review.

作者信息

Mayala Henry Anselmo, Bakari Khamis Hassan, Zhaohui Wang

机构信息

Wuhan Union Hospital, Tongji Medical College of Huazhong, University of Science and Technology, China.

出版信息

Malawi Med J. 2018 Dec;30(4):291-295. doi: 10.4314/mmj.v30i4.13.

Abstract

BACKGROUND

Myocardial pathologies are significant causes of morbidity and mortality in patients worldwide. Ischemic and non-ischemic cardiomyopathies have become a worldwide epidemic of the 21st century with an increasing impact on health care systems. The 2012 European Society of Cardiology and 2013 American College of Cardiology Foundation/American Heart Association guidelines provide current therapy guidance to reduce mortality and morbidity.

METHODS

This was a systematic review involving cardiac magnetic resonance (CMR) studies for the diagnosis of cardiomyopathy from January 2013 to April 2017. Out of 62 reviewed studies, only 12 were included in our study.

RESULTS

The average sensitivity and specificity of CMR in the diagnosis of cardiomyopathy was 86.75% (95% confidence interval [CI], 70.30% to 92.58%) and 81.75% (95% CI, 73.0% to 87.6%), respectively, and the positive predictive and negative predictive values were 80.17% and 86.75%, respectively.

CONCLUSION

Despite some limitations, our study shows that CMR has high sensitivity, specificity, and positive predictive value in diagnosing different types of cardiomyopathy. CMR may be used to differentiate types of cardiomyopathy, accurately quantify the chamber dimensions, volumes, and cardiac function, which make it useful for prognosis as well.

摘要

背景

心肌病变是全球患者发病和死亡的重要原因。缺血性和非缺血性心肌病已成为21世纪全球流行疾病,对医疗保健系统的影响日益增大。2012年欧洲心脏病学会和2013年美国心脏病学会基金会/美国心脏协会指南提供了降低死亡率和发病率的当前治疗指导。

方法

这是一项系统性综述,纳入了2013年1月至2017年4月期间利用心脏磁共振(CMR)研究诊断心肌病的相关研究。在62项经审查的研究中,只有12项被纳入我们的研究。

结果

CMR诊断心肌病的平均敏感性和特异性分别为86.75%(95%置信区间[CI],70.30%至92.58%)和81.75%(95%CI,73.0%至87.6%),阳性预测值和阴性预测值分别为80.17%和86.75%。

结论

尽管存在一些局限性,但我们的研究表明,CMR在诊断不同类型的心肌病方面具有较高的敏感性、特异性和阳性预测值。CMR可用于区分心肌病类型,准确量化心腔大小、容积和心脏功能,这对预后评估也很有用。

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