Kozak Marcelo Felipe, Afiune Jorge Yussef, Grosse-Wortmann Lars
Instituto de Cardiologia do Distrito Federal - Cardiologia Pediátrica, Brasília, DF - Brasil.
Hospital da Criança de Brasília José de Alencar - Ecocardiografia, Brasília, DF - Brasil.
Arq Bras Cardiol. 2021 Feb;116(2):305-312. doi: 10.36660/abc.20190860.
Data on the use of cardiac magnetic resonance imaging (CMR) on children in Brazil is lacking.
This study sought to provide information on current pediatric CMR practices in Brazil.
A questionnaire was sent out to referring physicians around the country. It covered information on the respondents, their CMR practices, the clinical context of the patients, and barriers to CMR use among children. For statistical analysis, two-sided p < 0.05 was considered significant.
The survey received 142 replies. CMR was reported to be available to 79% of the respondents, of whom, 52% rarely or never use CMR. The most common indications were found to be cardiomyopathies (84%), status of post-tetralogy of Fallot repair (81%), and aortic arch malformations (53%). Exam complexity correlated with CMR-to-surgery ratio (Rho = 0.48, 95% CI = 0.32-0.62, p < 0.0001) and with the number of CMR exams (Rho = 0.52, 95% CI = 0.38-0.64, p < 0.0001). Further, a high CMR complexity score was associated with pediatric cardiologists conducting the exams (OR 2.14, 95% CI 1.2-3.89, p < 0.01). The main barriers to a more frequent use of CMR were its high cost (65%), the need for sedation (60%), and an insufficient number of qualified professionals (55%).
Pediatric CMR is not used frequently in Brazil. The presence of a pediatric cardiologist who can perform CMR exams is associated with CMR use on more complex patients. Training pediatric CMR specialists and educating referring providers are important steps toward a broader use of CMR in Brazil. (Arq Bras Cardiol. 2021; 116(2):305-312).
巴西缺乏关于儿童使用心脏磁共振成像（CMR）的数据。
本研究旨在提供巴西当前儿科CMR实践的相关信息。
向全国范围内的转诊医生发送了一份调查问卷。问卷涵盖了受访者的信息、他们的CMR实践、患者的临床背景以及儿童CMR使用的障碍。统计分析时，双侧p<0.05被视为具有统计学意义。
该调查共收到142份回复。据报告，79%的受访者可以使用CMR，其中52%很少或从不使用CMR。最常见的适应症是心肌病（84%）、法洛四联症修复术后状态（81%）和主动脉弓畸形（53%）。检查复杂性与CMR与手术比例（Rho = 0.48，95%CI = 0.32 - 0.62，p < 0.0001）以及CMR检查数量（Rho = 0.52，95%CI = 0.38 - 0.64，p < 0.0001）相关。此外，CMR复杂性评分高与进行检查的儿科心脏病专家有关（OR 2.14，95%CI 1.2 - 3.89，p < 0.01）。更频繁使用CMR的主要障碍是成本高（65%）、需要镇静（60%）和合格专业人员数量不足（55%）。
巴西儿科CMR的使用并不频繁。能够进行CMR检查的儿科心脏病专家的存在与对更复杂患者使用CMR有关。培训儿科CMR专家并教育转诊提供者是巴西更广泛使用CMR的重要步骤。（《巴西心脏病学杂志》。2021年；116(2):305 - 312）
