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先天性心脏病中的心肌纤维化与MRI的作用

Myocardial Fibrosis in Congenital Heart Disease and the Role of MRI.

作者信息

DiLorenzo Michael P, Grosse-Wortmann Lars

机构信息

From the Division of Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children's Hospital, 3959 Broadway, CHN2, New York, NY 10032 (M.P.D.); and Division of Cardiology, Department of Pediatrics, Oregon Health and Science University, Portland, Ore (L.G.W.).

出版信息

Radiol Cardiothorac Imaging. 2023 Jun 1;5(3):e220255. doi: 10.1148/ryct.220255. eCollection 2023 Jun.

Abstract

Progress in the field of congenital heart surgery over the last century can only be described as revolutionary. Recent improvements in patient outcomes have been achieved through refinements in perioperative care. In the current and future eras, the preservation and restoration of myocardial health, beginning with the monitoring of tissue remodeling, will be central to improving cardiac outcomes. Visualization and quantification of fibrotic myocardial remodeling is one of the greatest assets that cardiac MRI brings to the field of cardiology, and its clinical use within the field of congenital heart disease (CHD) has been an area of particular interest in the last few decades. This review summarizes the physical underpinnings of myocardial tissue characterization in CHD, with an emphasis on T1 parametric mapping and late gadolinium enhancement. It describes methods and suggestions for obtaining images, extracting quantitative and qualitative data, and interpreting the results for children and adults with CHD. The tissue characterization observed in different lesions is used to examine the causes and pathomechanisms of fibrotic remodeling in this population. Similarly, the clinical consequences of elevated imaging biomarkers of fibrosis on patient health and outcomes are explored. Pediatrics, MR Imaging, Cardiac, Heart, Congenital, Tissue Characterization, Congenital Heart Disease, Cardiac MRI, Parametric Mapping, Fibrosis, Late Gadolinium Enhancement © RSNA, 2023.

摘要

上个世纪先天性心脏外科领域的进展只能说是革命性的。近期通过围手术期护理的优化实现了患者预后的改善。在当前和未来时代,从组织重塑监测开始,心肌健康的保护和恢复将是改善心脏预后的核心。纤维化心肌重塑的可视化和量化是心脏磁共振成像(MRI)给心脏病学领域带来的最大优势之一,在过去几十年里,其在先天性心脏病(CHD)领域的临床应用一直是特别受关注的领域。本综述总结了先天性心脏病中心肌组织特征的物理基础,重点是T1参数成像和延迟钆增强。它描述了获取图像、提取定量和定性数据以及为先天性心脏病儿童和成人解读结果的方法和建议。观察到的不同病变中的组织特征用于研究该人群纤维化重塑的原因和病理机制。同样,探讨了纤维化成像生物标志物升高对患者健康和预后的临床影响。儿科学、磁共振成像、心脏、心脏、先天性、组织特征、先天性心脏病、心脏磁共振成像、参数成像、纤维化、延迟钆增强 © RSNA,2023

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