Kamińska Halszka, Małek Łukasz A, Barczuk-Falęcka Marzena, Bartoszek Marta, Strzałkowska-Kominiak Ewa, Marszałek Mikołaj, Brzezik Ewa, Brzewski Michał, Werner Bożena
Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland.
Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, 04-635 Warsaw, Poland.
J Clin Med. 2021 Mar 24;10(7):1335. doi: 10.3390/jcm10071335.
The aim of the study was to assess the role of cardiovascular magnetic resonance (CMR) in the diagnosis of idiopathic VA in children. This retrospective single-centre study included a total of 80 patients with idiopathic ventricular arrhythmia that underwent routine CMR imaging between 2016 and 2020 at our institution. All patients underwent a 3.0 T scan involving balanced steady-state free precession cine images as well as dark-blood T2W images and assessment of late gadolinium enhancement (LGE). In 26% of patients ( = 21) CMR revealed cardiac abnormalities, in 20% ( = 16) not suspected on prior echocardiography. The main findings included: non-ischemic ventricular scars ( = 8), arrhythmogenic right ventricular cardiomyopathy ( = 6), left ventricular clefts ( = 4) and active myocarditis ( = 3). LGE was present in 57% of patients with abnormal findings. Univariate predictors of abnormal CMR result included abnormalities in echocardiography and severe VA (combination of >10% of 24 h VA burden and/or presence of ventricular tachycardia and/or polymorphic VA). CMR provides valuable clinical information in many cases of idiopathic ventricular arrhythmia in children, mainly due to its advanced tissue characterization capabilities and potential to assess the right ventricle.
本研究的目的是评估心血管磁共振成像（CMR）在儿童特发性室性心律失常（VA）诊断中的作用。这项回顾性单中心研究共纳入了80例特发性室性心律失常患者，这些患者于2016年至2020年在我院接受了常规CMR成像检查。所有患者均接受了3.0 T扫描，包括平衡稳态自由进动电影图像、黑血T2加权图像以及延迟钆增强（LGE）评估。26%的患者（n = 21）CMR显示心脏异常，其中20%（n = 16）在之前的超声心动图检查中未被怀疑。主要发现包括：非缺血性心室瘢痕（n = 8）、致心律失常性右室心肌病（n = 6）、左心室裂隙（n = 4）和活动性心肌炎（n = 3）。有异常发现的患者中57%存在LGE。CMR结果异常的单因素预测因素包括超声心动图异常和严重VA（24小时VA负荷>10%和/或存在室性心动过速和/或多形性VA的组合）。CMR在许多儿童特发性室性心律失常病例中提供了有价值的临床信息，主要是由于其先进的组织特征分析能力和评估右心室的潜力。
