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心脏 CT 和 MRI 在原发性心脏淋巴瘤的诊断和治疗中的作用:全面综述。

The role of cardiac CT and MRI in the diagnosis and management of primary cardiac lymphoma: A comprehensive review.

机构信息

Rajaie Cardiovascular Medical and Research Center, Tehran, Iran.

Rajaie Cardiovascular Medical and Research Center, Tehran, Iran.

出版信息

Trends Cardiovasc Med. 2022 Oct;32(7):408-420. doi: 10.1016/j.tcm.2021.08.010. Epub 2021 Aug 25.

Abstract

Primary cardiac tumors comprise a distinct category of disorders that result in significant cardiac complications. Primary cardiac lymphomas (PCLs) constitute the second most frequent primary malignancy involving the heart. Without treatment, survival may be limited to just a few months; however, a timely therapeutic schedule may prolong the five-year survival. Accordingly, robust diagnostic modalities are essential to improve prognosis. We herein review the literature available in PubMed, MEDLINE, Cochrane, Google Scholar and Scopus databases. Our review demonstrated that cardiac computed tomography (CT) and magnetic resonance imaging (MRI) employ multiple advanced sequences for tumor characterization with or without a contrast agent. These methods assist not only in differentiating PCLs from other cardiac masses such as cardiac thrombi but also in defining the extent of PCLs and conducting a safe biopsy. Cardiac magnetic resonance (CMR) and CT imaging provide essential knowledge regarding PCLs and cardiotoxicity induced by therapeutic regimens. The application of these robust imaging modalities aids in the early diagnosis of PCLs, accelerates the initiation of the treatment program, and improves patient outcomes significantly. Also presented is our introduction into novel techniques and the feasibility of their use to diagnose and treat cardiac masses, particularly PCLs. It should be mentioned that the paramount role of FDG-PET was not the focus of this paper.

摘要

原发性心脏肿瘤是一类会导致严重心脏并发症的疾病。原发性心脏淋巴瘤(PCL)是仅次于心脏的第二大原发性恶性肿瘤。如果不治疗,患者的生存时间可能只有短短几个月;但如果及时进行治疗,五年生存率可能会延长。因此,采用强大的诊断方式对于改善预后至关重要。我们在 PubMed、MEDLINE、Cochrane、Google Scholar 和 Scopus 数据库中对相关文献进行了回顾。我们的综述表明,心脏计算机断层扫描(CT)和磁共振成像(MRI)可采用多种先进的序列来对肿瘤进行特征描述,无论是否使用造影剂。这些方法不仅有助于将 PCL 与其他心脏肿块(如心脏血栓)区分开来,还有助于确定 PCL 的范围并进行安全的活检。心脏磁共振(CMR)和 CT 成像可为 PCL 和治疗方案引起的心脏毒性提供重要信息。这些强大的成像方式的应用有助于早期诊断 PCL,加速治疗方案的启动,并显著改善患者的预后。此外,我们还介绍了一些新技术,并探讨了其在诊断和治疗心脏肿块(特别是 PCL)方面的应用前景。需要指出的是,本研究并未重点探讨 FDG-PET 的重要作用。

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