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[先天性心脏病的影像学检查,重点为磁共振成像和计算机断层扫描]

[Imaging of congenital heart defects with a focus on magnetic resonance imaging and computed tomography].

作者信息

Renz Diane Miriam, Böttcher Joachim, Eckstein Jan, Huisinga Carolin, Pfeil Alexander, Lücke Christian, Gutberlet Matthias

机构信息

Institut für Diagnostische und Interventionelle Radiologie, Arbeitsbereich Kinderradiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Friedrich-Schiller-Universität Jena, Jena, Deutschland.

出版信息

Radiologie (Heidelb). 2024 May;64(5):382-391. doi: 10.1007/s00117-024-01301-4. Epub 2024 Apr 24.

Abstract

CLINICAL ISSUE

Due to advances in diagnostics and therapy, the survival rate of patients with congenital heart defects is continuously increasing. The aim of this review is to compare various imaging modalities that are used in the diagnosis of congenital heart defects.

METHODS

Transthoracic echocardiography is the imaging method of choice in the presence of a congenital heart defect because of its wide availability and non-invasiveness. It can be complemented by transesophageal echocardiography, cardiac catheterization, computed tomography (CT), and magnetic resonance imaging (MRI) of the heart and vessels close to the heart.

METHODICAL INNOVATIONS

The radiation exposure of CT examinations of the heart is continuously decreasing because of improved technologies. MRI is also being continuously optimized, e.g., by the acquisition of MR angiographies without contrast medium application or a thin three-dimensional (3D) visualization of the entire heart with the possibility of reconstruction in all spatial planes (whole-heart technique) as well as 2D to 4D flow.

PRACTICAL RECOMMENDATION

Due to the complexity of congenital heart defects and the variety of possible pathologies, the choice of imaging modality and its exact performance has to be coordinated in an interdisciplinary context and individually adapted.

摘要

临床问题

由于诊断和治疗技术的进步,先天性心脏病患者的存活率在不断提高。本综述的目的是比较用于诊断先天性心脏病的各种成像方式。

方法

经胸超声心动图因其广泛可用性和非侵入性,是先天性心脏病存在时的首选成像方法。它可以通过经食管超声心动图、心导管检查、计算机断层扫描(CT)以及心脏和心脏附近血管的磁共振成像(MRI)来补充。

方法创新

由于技术改进,心脏CT检查的辐射暴露在不断减少。MRI也在不断优化,例如,通过在不使用造影剂的情况下采集磁共振血管造影,或对整个心脏进行薄层三维(3D)可视化,并能够在所有空间平面上进行重建(全心技术)以及二维到四维血流成像。

实际建议

由于先天性心脏病的复杂性和可能的病理情况的多样性,成像方式的选择及其确切操作必须在跨学科背景下进行协调,并根据个体情况进行调整。

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