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[用于炎症性心肌病的PET/MRI融合成像]

[Hybrid PET/MRI for inflammatory cardiomyopathy].

作者信息

Krumm Patrick, Greulich Simon, la Fougère Christian, Nikolaou Konstantin

机构信息

Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland.

Innere Medizin III, Kardiologie und Angiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland.

出版信息

Radiologie (Heidelb). 2022 Nov;62(11):954-959. doi: 10.1007/s00117-022-01064-w. Epub 2022 Sep 2.

DOI:10.1007/s00117-022-01064-w
PMID:36056155
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9613732/
Abstract

BACKGROUND

Diagnostic work-up for myocarditis and inflammatory cardiomyopathy is challenging for its different aetiologies, phenotypes and stages.

METHODICAL INNOVATIONS AND CHALLENGES

Cardiac PET/MRI is an excellent tool for myocardial tissue characterization with MRI as well as for diagnosis of active myocardial inflammation with PET. The combination of MRI and PET is rather synergistic than only summative: myocardial changes detected by MRI can be differentiated with PET to (potentially still reversible) active inflammation vs. chronic and inactive (irreversible) scars. The strengths of a hybrid PET/MRI can show to advantage in cardiac sarcoidosis with potentially coexistent active and chronic involvement. Good dietary preparation with a low-carb diet is essential to warrant sufficient suppression of myocardial glucose uptake for robust cardiac PET in context of inflammatory cardiomyopathy.

RECOMMENDATIONS

Hybrid cardiac PET/MRI to diagnose inflammatory cardiomyopathy and further differentiation in acute vs. chronic processes is feasible. This could be demonstrated in cardiac involvement of sarcoidosis.

摘要

背景

心肌炎和炎症性心肌病的诊断检查因其不同的病因、表型和阶段而具有挑战性。

方法创新与挑战

心脏PET/MRI是用于心肌组织特征分析的MRI以及用于诊断活动性心肌炎症的PET的优秀工具。MRI和PET的结合具有协同作用而非仅仅是累加：MRI检测到的心肌变化可通过PET区分为（可能仍可逆的）活动性炎症与慢性和非活动性（不可逆的）瘢痕。混合型PET/MRI的优势在可能同时存在活动性和慢性病变的心脏结节病中得以体现。在炎症性心肌病的情况下，采用低碳水化合物饮食进行良好的饮食准备对于确保充分抑制心肌葡萄糖摄取以进行可靠的心脏PET检查至关重要。

建议

混合型心脏PET/MRI用于诊断炎症性心肌病并进一步区分急性与慢性过程是可行的。这在结节病的心脏受累中得到了证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e95/9613732/ac23916f1956/117_2022_1064_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e95/9613732/278c17481c5d/117_2022_1064_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e95/9613732/bcbe8a6d651a/117_2022_1064_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e95/9613732/4a666c357eec/117_2022_1064_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e95/9613732/ac23916f1956/117_2022_1064_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e95/9613732/278c17481c5d/117_2022_1064_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e95/9613732/bcbe8a6d651a/117_2022_1064_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e95/9613732/4a666c357eec/117_2022_1064_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e95/9613732/ac23916f1956/117_2022_1064_Fig4_HTML.jpg

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本文引用的文献

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Role of Cardiovascular Magnetic Resonance to Assess Cardiovascular Inflammation.心血管磁共振在评估心血管炎症中的作用。
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心脏结节病和巨细胞心肌炎的诊断、治疗和转归：瑞典单中心经验。
BMC Cardiovasc Disord. 2022 Apr 26;22(1):192. doi: 10.1186/s12872-022-02639-0.
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Combined simultaneous FDG-PET/MRI with T1 and T2 mapping as an imaging biomarker for the diagnosis and prognosis of suspected cardiac sarcoidosis.联合同时进行的 FDG-PET/MRI 及 T1 和 T2 映射作为疑似心脏结节病诊断和预后的成像生物标志物。
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