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心脏磁共振成像在乳腺癌患者治疗后心脏毒性检测与监测中的作用:一项综述

The role of cardiac magnetic resonance imaging in the detection and monitoring of cardiotoxicity in patients with breast cancer after treatment: a comprehensive review.

作者信息

Jafari Fatemeh, Safaei Afsane Maddah, Hosseini Leila, Asadian Sanaz, Kamangar Tara Molanaie, Zadehbagheri Fatemeh, Rezaeian Nahid

机构信息

Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.

Radiation Oncology Research Center (RORC), Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Heart Fail Rev. 2021 May;26(3):679-697. doi: 10.1007/s10741-020-10028-y. Epub 2020 Oct 7.

Abstract

The use of chemotherapy medicines for breast cancer (BC) has been associated with an increased risk of cardiotoxicity. In recent years, there have been growing interests regarding the application of cardiovascular magnetic resonance (CMR) imaging, a safe and noninvasive modality, with the potential to identify subtle morphological and functional changes in the myocardium. In this investigation, we aimed to review the performance of various CMR methods in diagnosing cardiotoxicity in BC, induced by chemotherapy or radiotherapy. For this purpose, we reviewed the literature available in PubMed, MEDLINE, Cochrane, Google Scholar, and Scopus databases. Our literature review showed that CMR is a valuable modality for identifying and predicting subclinical cardiotoxicity induced by chemotherapy. The novel T1, T2, and extracellular volume mapping techniques may provide critical information about cardiotoxicity, in addition to other CMR features such as functional and structural changes. However, further research is needed to verify the exact role of these methods in identifying cardiotoxicity and patient management. Since multiple studies have reported the improvement of left ventricular performance following the termination of chemotherapy regimens, CMR remains an essential imaging tool for the prediction of cardiotoxicity and, consequently, decreases the mortality rate of BC due to heart failure.

摘要

乳腺癌(BC)化疗药物的使用与心脏毒性风险增加有关。近年来,人们对心血管磁共振(CMR)成像的应用越来越感兴趣,这是一种安全且无创的检查方式,有潜力识别心肌细微的形态和功能变化。在本研究中,我们旨在回顾各种CMR方法在诊断BC化疗或放疗所致心脏毒性方面的表现。为此,我们检索了PubMed、MEDLINE、Cochrane、谷歌学术和Scopus数据库中的文献。我们的文献综述表明,CMR是识别和预测化疗所致亚临床心脏毒性的重要手段。除了其他CMR特征(如功能和结构变化)外,新型T1、T2和细胞外容积映射技术可能提供有关心脏毒性的关键信息。然而,需要进一步研究以验证这些方法在识别心脏毒性和患者管理中的确切作用。由于多项研究报告化疗方案终止后左心室功能有所改善,CMR仍然是预测心脏毒性的重要成像工具,从而降低了BC因心力衰竭导致的死亡率。

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