Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Cape Universities Body Imaging Centre, Faculty of Health Sciences, University of Cape Town, South Africa.
Int J Cardiol. 2021 Feb 15;325:176-185. doi: 10.1016/j.ijcard.2020.09.049. Epub 2020 Sep 25.
Rheumatic heart disease (RHD) is prevalent in sub-Saharan Africa, where the capacity for diagnosis and evaluation of disease severity and complications is not always optimal. While the medical history and physical examination are important in the assessment of patients suspected to have RHD, cardiovascular imaging techniques are useful for confirmation of the diagnosis. Echocardiography is the workhorse modality for initial evaluation and diagnosis of RHD. Cardiovascular magnetic resonance is complementary and may provide additive information, including tissue characteristics, where echocardiography is inadequate or non-diagnostic. There is emerging evidence on the role of computed tomography, particularly following valve replacement surgery, in the monitoring and management of RHD. This article summarises the techniques used in imaging RHD patients, considers the evidence base for their utility, discusses their limitations and recognises the clinical contexts in which indications and imaging with various modalities are expanding.
风湿性心脏病（Rheumatic heart disease，RHD）在撒哈拉以南非洲很常见，但该地区对疾病严重程度和并发症的诊断和评估能力并不总是理想的。虽然病史和体格检查对于疑似患有 RHD 的患者的评估很重要，但心血管成像技术对于确诊该病很有用。超声心动图是最初评估和诊断 RHD 的主要手段。心血管磁共振成像（Cardiovascular magnetic resonance，CMR）是一种补充手段，在超声心动图不充分或无法诊断时，可以提供包括组织特征在内的附加信息。越来越多的证据表明，计算机断层扫描（Computed tomography，CT）在 RHD 患者的监测和管理中具有一定作用，特别是在瓣膜置换手术后。本文总结了用于 RHD 患者成像的技术，考虑了其效用的证据基础，讨论了其局限性，并认识到在哪些临床情况下，各种成像方式的适应证和应用正在扩大。
