Erley Jennifer, Beitzen-Heineke Antonia, Tahir Enver
Zentrum für Radiologie und Endoskopie, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland.
Zentrum für Onkologie, II. Medizinische Klinik und Poliklinik (Onkologie, Hämatologie, Knochenmarktransplantation mit Abteilung für Pneumologie), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Radiologie (Heidelb). 2022 Nov;62(11):941-946. doi: 10.1007/s00117-022-01055-x. Epub 2022 Aug 15.
With rapidly increasing survival chances of cancer patients, the potential side effects of cancer therapeutics are increasingly relevant and a potentially lifelong issue. If cardiotoxic effects are not detected at a reversible stage, this might result in irreversible heart failure.
This article will portray the current state of knowledge on the use of cardiac magnetic resonance imaging (cardiac MRI) in the field of cardio-oncology. The aim is to provide an overview of the advantages of cardiac MRI to determine myocardial function and analyze inflammatory or fibrotic myocardial changes.
Current studies on this topic were collected and evaluated. Expert recommendations from various position papers were reviewed and summarized. Lastly, an MRI protocol to assess potential cardiotoxic effects of cancer therapeutics was discussed.
Up to 20% of patients are reported to suffer from cancer therapeutics-related cardiac dysfunction (CTRCD). Especially those with cardiovascular risk factors should receive pre- and posttherapeutic monitoring of heart function. Cardiac MRI is currently suggested as an imaging tool to analyze myocardial function if echocardiographic assessment is insufficient. However, cardiac MRI is also an excellent method for additional tissue analysis.
Current consensus statements recommend cardiac MRI as optional in cases where echocardiography image quality is not adequate. Nevertheless, patients with reduced heart function on echocardiography might benefit from early assessment of inflammatory or fibrotic changes due to CTRCD using cardiac MRI.
随着癌症患者生存几率的迅速提高，癌症治疗的潜在副作用日益凸显，且可能是一个终身问题。如果在可逆阶段未检测到心脏毒性作用，可能会导致不可逆的心力衰竭。
本文将阐述心脏磁共振成像（心脏MRI）在心脏肿瘤学领域应用的当前知识状态。目的是概述心脏MRI在确定心肌功能以及分析炎症性或纤维化性心肌变化方面的优势。
收集并评估了关于该主题的当前研究。对各种立场文件中的专家建议进行了审查和总结。最后，讨论了一种评估癌症治疗潜在心脏毒性作用的MRI方案。
据报道，高达20%的患者患有与癌症治疗相关的心脏功能障碍（CTRCD）。尤其是那些有心血管危险因素的患者，应在治疗前和治疗后接受心脏功能监测。如果超声心动图评估不足，目前建议将心脏MRI作为分析心肌功能的成像工具。然而，心脏MRI也是进行额外组织分析的优秀方法。
当前的共识声明建议，在超声心动图图像质量不足的情况下，心脏MRI为可选检查。尽管如此，超声心动图显示心脏功能降低的患者，可能会受益于使用心脏MRI对CTRCD所致炎症性或纤维化性变化进行的早期评估。
