Kolling Institute, Royal North Shore Hospital and University of Sydney, Sydney, Australia; Department of Clinical Physiology, Research and Development, Växjö Central Hospital, Region Kronoberg, Sweden; Clinical Physiology, Clinical Sciences, Lund University, Sweden.
Kolling Institute, Royal North Shore Hospital and University of Sydney, Sydney, Australia.
JACC Cardiovasc Imaging. 2023 Nov;16(11):1469-1484. doi: 10.1016/j.jcmg.2023.06.023. Epub 2023 Aug 23.
Quantification of pulmonary edema and congestion is important to guide diagnosis and risk stratification, and to objectively evaluate new therapies in heart failure. Herein, we review the validation, diagnostic performance, and clinical utility of noninvasive imaging modalities in this setting, including chest x-ray, lung ultrasound (LUS), computed tomography (CT), nuclear medicine imaging methods (positron emission tomography [PET], single photon emission CT), and magnetic resonance imaging (MRI). LUS is a clinically useful bedside modality, and fully quantitative methods (CT, MRI, PET) are likely to be important contributors to a more accurate and precise evaluation of new heart failure therapies and for clinical use in conjunction with cardiac imaging. There are only a limited number of studies evaluating pulmonary congestion during stress. Taken together, noninvasive imaging of pulmonary congestion provides utility for both clinical and research assessment, and continued refinement of methodologic accuracy, validation, and workflow has the potential to increase broader clinical adoption.
肺水和淤血的定量对于指导诊断和风险分层，以及客观评估心力衰竭的新疗法非常重要。在此，我们综述了非侵入性影像学方法在这一领域的验证、诊断性能和临床应用，包括胸部 X 线摄影、肺部超声（LUS）、计算机断层扫描（CT）、核医学成像方法（正电子发射断层扫描[PET]、单光子发射 CT）和磁共振成像（MRI）。LUS 是一种临床有用的床边方法，而完全定量的方法（CT、MRI、PET）可能是更准确、更精确地评估心力衰竭新疗法的重要手段，并与心脏成像一起用于临床。只有少数研究评估了应激期间的肺淤血。总之，肺淤血的非侵入性成像为临床和研究评估提供了帮助，并且不断改进方法学的准确性、验证和工作流程有可能增加更广泛的临床应用。
