Department of Medicine, College of Medicine, University of Illinois at Chicago.
Department of Medicine, Jesse Brown VA Medical Center, Chicago, Illinois.
Curr Opin Pulm Med. 2021 Sep 1;27(5):478-483. doi: 10.1097/MCP.0000000000000808.
Cardiac sarcoidosis has high prevalence in sarcoidosis patients and contributes to significant morbidity and mortality. Early detection of cardiac sarcoidosis is essential to improving patients' symptoms and cardiovascular outcomes.
Cardiovascular magnetic resonance imaging (CMR) is an excellent diagnostic modality for cardiac sarcoidosis. However, early phenotypes of cardiac sarcoidosis have more mild imaging phenotypes. These mild and sometimes subtle imaging phenotypes of cardiac sarcoidosis have lower diagnostic sensitivity and specificity for cardiac sarcoidosis by CMR when compared with more severe imaging phenotypes of cardiac sarcoidosis. In addition, many sarcoidosis patient cohorts frequently have heterogenous potential alternative etiologies for mild myocardial disease detected by mild late gadolinium enhancement (LGE) findings. In early phenotype cardiac sarcoidosis, analysis of the LGE pattern and location can improve the diagnostic specificity of these mild LGE findings.
The current review focuses on the current strengths and challenges in CMR detection of early phenotypes of cardiac sarcoidosis by the LGE technique.
心脏结节病在结节病患者中的患病率很高，会导致发病率和死亡率显著增加。早期发现心脏结节病对于改善患者症状和心血管结局至关重要。
心血管磁共振成像（CMR）是心脏结节病的一种极好的诊断方式。然而，心脏结节病的早期表型具有更轻微的影像学表现。与心脏结节病更严重的影像学表现相比，CMR 对心脏结节病的诊断敏感性和特异性较低，因为这些轻微且有时微妙的心脏结节病影像学表现与心脏结节病的相关性较低。此外，许多结节病患者队列中，经常存在由轻度延迟钆增强（LGE）发现引起的轻度心肌疾病的异质性潜在替代病因。在早期表型心脏结节病中，分析 LGE 模式和位置可以提高这些轻度 LGE 发现的诊断特异性。
本综述重点介绍了 LGE 技术在心脏结节病早期表型的 CMR 检测中的优势和挑战。
