Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA.
Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University, West Hospital, 8th Floor, 1200 E. Broad Street, Richmond, VA, 23298, USA.
Curr Cardiol Rep. 2022 Nov;24(11):1529-1536. doi: 10.1007/s11886-022-01770-w. Epub 2022 Aug 19.
This focused report aims to discuss and summarize the use of conventional and emerging methods using cardiovascular magnetic resonance (CMR) imaging in cardiomyopathy patients with implanted cardiac devices to identify diffuse and focal inflammation and fibrosis.
Many cardiomyopathy patients with diffuse and focal myocardial fibrosis have a unique need for cardiac imaging that is complicated by cardiovascular implantable electronic devices (CIEDs). CMR imaging can accurately image myocardial fibrosis and inflammation using T1 mapping and late gadolinium enhancement (LGE) imaging. CMR imaging in CIED patients, however, has been limited due to severe imaging artifacts associated with the devices. The emergence of wideband imaging variants of LGE and T1 mapping techniques can successfully reduce or eliminate CIED artifacts for the evaluation of myocardial substrate in cardiomyopathy patients. Wideband imaging variants of LGE and T1 mapping techniques provide new tools for imaging focal and diffuse fibrosis and imaging in cardiomyopathy patients with implanted cardiac devices. These emerging techniques have the potential for great impact in clinical care of such patients as well as clinical research where imaging endpoints are desired.
本重点报告旨在讨论和总结使用心血管磁共振（CMR）成像在植入心脏装置的心肌病患者中识别弥漫性和局灶性炎症和纤维化的常规和新兴方法的应用。
许多患有弥漫性和局灶性心肌纤维化的心肌病患者对心脏成像有独特的需求，而心血管植入电子设备（CIED）使这种需求变得复杂。CMR 成像可以使用 T1 映射和晚期钆增强（LGE）成像准确地对心肌纤维化和炎症进行成像。然而，由于与设备相关的严重成像伪影，CIED 患者的 CMR 成像受到限制。LGE 和 T1 映射技术的宽带成像变体的出现可以成功地减少或消除 CIED 伪影，从而评估心肌病患者的心肌底物。LGE 和 T1 映射技术的宽带成像变体为成像有植入心脏装置的心肌病患者的局灶性和弥漫性纤维化以及成像提供了新工具。这些新兴技术有可能对这些患者的临床护理以及需要成像终点的临床研究产生重大影响。
