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[氧合敏感心脏磁共振成像]

[Oxygenation-sensitive cardiac magnetic resonance imaging].

作者信息

Weberling L D, Friedrich M G

机构信息

Klinik für Kardiologie, Angiologie und Pneumologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.

Deutsches Zentrum für Herz-Kreislauf-Forschung, Standort Heidelberg/Mannheim, Deutschland.

出版信息

Radiologie (Heidelb). 2022 Nov;62(11):971-976. doi: 10.1007/s00117-022-01049-9. Epub 2022 Jul 29.

DOI:10.1007/s00117-022-01049-9
PMID:35904573
Abstract

BACKGROUND

Oxygenation-sensitive cardiac magnetic resonance imaging (OS-CMR) is an evolving cardiac imaging technique offering new perspectives to understand, predict, and diagnose cardiac pathologies.

OBJECTIVES

To provide an overview of the basic principles of OS-CMR, the current diagnostic applications and how it may aid in future diagnostic challenges.

MATERIALS AND METHODS

Description, analysis, and interpretation of the current literature on basic research and applicational studies in both humans and animals assessing OS-CMR.

RESULTS

OS-CMR is based on the paramagnetic properties of deoxygenated hemoglobin, which is visualized by a T2*-sensitive sequence. The measured signal correlates with the oxygenation of the myocardium and can analyze vascular function during pharmacological vasodilation or vasoactive breathing exercises (hyperventilation, apnea). The herewith triggered changes in myocardial oxygenation and oxygenation reserve can be used to identify relevant stenoses in coronary artery disease. Other areas of application involve myocardial hypertrophy, microvascular dysfunction, and pulmonary hypertension.

CONCLUSION

A broad number of applications for the clinical use of OS-CMR exist so far, especially in combination with breathing exercises. OS-CMR can be conducted medication- and needle-free. Limitations involve the current lack of clinically approved, automated evaluation tools and the unavailability of vendor- and site-independent normal values.

摘要

背景

氧敏感心脏磁共振成像(OS-CMR)是一种不断发展的心脏成像技术,为理解、预测和诊断心脏疾病提供了新的视角。

目的

概述OS-CMR的基本原理、当前的诊断应用以及它如何有助于应对未来的诊断挑战。

材料与方法

对评估OS-CMR的人体和动物基础研究及应用研究的当前文献进行描述、分析和解读。

结果

OS-CMR基于脱氧血红蛋白的顺磁特性,通过T2*敏感序列进行可视化。所测量的信号与心肌的氧合相关,并且可以在药物性血管舒张或血管活性呼吸练习(过度通气、屏气)期间分析血管功能。由此引发的心肌氧合和氧储备变化可用于识别冠状动脉疾病中的相关狭窄。其他应用领域包括心肌肥厚、微血管功能障碍和肺动脉高压。

结论

目前OS-CMR在临床应用中有广泛的用途,尤其是与呼吸练习相结合时。OS-CMR无需用药和穿刺。局限性包括目前缺乏临床认可的自动化评估工具以及缺乏供应商和站点独立的正常值。

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[Oxygenation-sensitive cardiac magnetic resonance imaging].[氧合敏感心脏磁共振成像]
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本文引用的文献

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Insights Into Myocardial Oxygenation and Cardiovascular Magnetic Resonance Tissue Biomarkers in Heart Failure With Preserved Ejection Fraction.射血分数保留的心力衰竭中心肌氧合和心血管磁共振组织生物标志物的研究进展。
Circ Heart Fail. 2022 Apr;15(4):e008903. doi: 10.1161/CIRCHEARTFAILURE.121.008903. Epub 2022 Jan 18.
2
The Potential of Oxygenation-Sensitive CMR in Heart Failure.氧敏感 CMR 在心力衰竭中的应用潜力。
Curr Heart Fail Rep. 2021 Oct;18(5):304-314. doi: 10.1007/s11897-021-00525-y. Epub 2021 Aug 11.
3
Regional Heterogeneity in the Coronary Vascular Response in Women With Chest Pain and Nonobstructive Coronary Artery Disease.
胸痛且冠状动脉无阻塞性病变的女性患者冠状动脉血管反应的区域异质性
Circulation. 2021 Feb 16;143(7):764-766. doi: 10.1161/CIRCULATIONAHA.120.052520. Epub 2021 Feb 15.
4
Left ventricular ischemia in pre-capillary pulmonary hypertension: a cardiovascular magnetic resonance study.毛细血管前性肺动脉高压中的左心室缺血:一项心血管磁共振研究
Cardiovasc Diagn Ther. 2020 Oct;10(5):1280-1292. doi: 10.21037/cdt-20-698.
5
Myocardial Vascular Function Assessed by Dynamic Oxygenation-sensitive Cardiac Magnetic Resonance Imaging Long-term Following Cardiac Transplantation.心脏移植后长期通过动态氧敏感心脏磁共振成像评估心肌血管功能。
Transplantation. 2021 Jun 1;105(6):1347-1355. doi: 10.1097/TP.0000000000003419.
6
Tracking Myocardial Oxygenation over a Breath Hold with Blood Oxygen Level-Dependent MRI: A Radically Different Approach to Study Ischemia.利用血氧水平依赖性功能磁共振成像追踪屏气过程中心肌氧合:一种研究心肌缺血的全新方法
Radiology. 2020 Mar;294(3):546-547. doi: 10.1148/radiol.2020192674. Epub 2020 Jan 21.
7
Cardiovascular risk is associated with a transmural gradient of myocardial oxygenation during adenosine infusion.在腺苷输注期间,心血管风险与心肌氧合的跨壁梯度相关。
Eur Heart J Cardiovasc Imaging. 2019 Nov 1;20(11):1287-1295. doi: 10.1093/ehjci/jey202.
8
Feasibility of cardiovascular magnetic resonance to detect oxygenation deficits in patients with multi-vessel coronary artery disease triggered by breathing maneuvers.呼吸动作诱发多支冠状动脉疾病患者的心血管磁共振检测氧合不足的可行性。
J Cardiovasc Magn Reson. 2018 May 7;20(1):31. doi: 10.1186/s12968-018-0446-y.
9
Impact of hyperventilation and apnea on myocardial oxygenation in patients with obstructive sleep apnea - An oxygenation-sensitive CMR study.过度通气和呼吸暂停对阻塞性睡眠呼吸暂停患者心肌氧合的影响——一项氧合敏感的心脏磁共振成像研究。
J Cardiol. 2017 Feb;69(2):489-494. doi: 10.1016/j.jjcc.2016.03.011. Epub 2016 May 30.
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Circ Heart Fail. 2015 Nov;8(6):1088-93. doi: 10.1161/CIRCHEARTFAILURE.114.002169. Epub 2015 Sep 2.