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心脏磁共振成像在新型冠状病毒肺炎相关心肌炎诊断与管理中的作用:临床与影像学考量

Role of cardiac magnetic resonance imaging in the diagnosis and management of COVID-19 related myocarditis: Clinical and imaging considerations.

作者信息

Atri Lavannya, Morgan Michael, Harrell Sean, AlJaroudi Wael, Berman Adam E

机构信息

Division of Cardiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States.

出版信息

World J Radiol. 2021 Sep 28;13(9):283-293. doi: 10.4329/wjr.v13.i9.283.

Abstract

There is a growing evidence of cardiovascular complications in coronavirus disease 2019 (COVID-19) patients. As evidence accumulated of COVID-19 mediated inflammatory effects on the myocardium, substantial attention has been directed towards cardiovascular imaging modalities that facilitate this diagnosis. Cardiac magnetic resonance imaging (CMRI) is the gold standard for the detection of structural and functional myocardial alterations and its role in identifying patients with COVID-19 mediated cardiac injury is growing. Despite its utility in the diagnosis of myocardial injury in this population, CMRI's impact on patient management is still evolving. This review provides a framework for the use of CMRI in diagnosis and management of COVID-19 patients from the perspective of a cardiologist. We review the role of CMRI in the management of both the acutely and remotely COVID-19 infected patient. We discuss patient selection for this imaging modality; T1, T2, and late gadolinium enhancement imaging techniques; and previously described CMRI findings in other cardiomyopathies with potential implications in COVID-19 recovered patients.

摘要

越来越多的证据表明2019冠状病毒病(COVID-19)患者存在心血管并发症。随着COVID-19对心肌介导的炎症作用的证据不断积累,人们对有助于这种诊断的心血管成像方式给予了大量关注。心脏磁共振成像(CMRI)是检测心肌结构和功能改变的金标准,其在识别COVID-19介导的心脏损伤患者中的作用日益凸显。尽管CMRI在诊断该人群的心肌损伤方面具有实用性,但其对患者管理的影响仍在不断发展。本综述从心脏病专家的角度提供了一个使用CMRI诊断和管理COVID-19患者的框架。我们回顾了CMRI在急性和远期COVID-19感染患者管理中的作用。我们讨论了这种成像方式的患者选择;T1、T2和钆延迟增强成像技术;以及先前描述的CMRI在其他心肌病中的表现及其对COVID-19康复患者的潜在影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a71/8473436/0ff0630394c4/WJR-13-283-g001.jpg

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