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多模态成像在心脏切开术后综合征诊断和管理中的新兴作用

The Emerging Role of Multimodality Imaging in the Diagnosis and Management of Post Pericardiotomy Syndrome.

作者信息

Alqahtani Mohammad, Mardigyan Vartan, Chetrit Michael

机构信息

Division of Cardiology, McGill University Health Centre, 845 Rue Sherbrooke O, Montreal, QC, H3H 0G4, Canada.

Division of Cardiology, Jewish General Hospital, 3755 Chem. de la Côte-Sainte- Catherine, Montréal, QC, H3T 1E2, Canada.

出版信息

Curr Cardiol Rep. 2025 Jan 4;27(1):1. doi: 10.1007/s11886-024-02158-8.

Abstract

PURPOSE OF REVIEW

This review aims to evaluate current diagnostic and therapeutic strategies for postpericardiotomy syndrome (PPS), with a focus on the evolving role of multimodality imaging, including echocardiography, cardiac computed tomography (CCT), and cardiac magnetic resonance imaging (CMR). The review also explores the potential benefits of advanced imaging in improving the accuracy and management of PPS.

RECENT FINDINGS

PPS, a common complication following cardiac surgery, presents with pleuritic chest pain, fever, and pericardial or pleural effusion. Traditional diagnostic methods like echocardiography and X-ray are increasingly supplemented by advanced imaging modalities such as CCT and CMR. These tools allow for better visualization of pericardial inflammation and effusion, aiding in diagnosis and guiding treatment. Colchicine and NSAIDs remain the most effective treatments for PPS, while the role of corticosteroids remains uncertain. Biological treatments have shown promising results in managing recurrent pericarditis. This review presents a proposed algorithm for the diagnosis and management of PPS, drawing on our institutional experience. Multimodality imaging is emerging as an essential tool in diagnosing and managing PPS. It enhances diagnostic precision, informs treatment strategies, and provides prognostic insights. As imaging technology advances, integrating these modalities into PPS care has the potential to improve patient outcomes.

摘要

综述目的

本综述旨在评估心包切开术后综合征(PPS)的当前诊断和治疗策略,重点关注多模态成像(包括超声心动图、心脏计算机断层扫描(CCT)和心脏磁共振成像(CMR))不断演变的作用。本综述还探讨了先进成像在提高PPS诊断准确性和管理方面的潜在益处。

最新发现

PPS是心脏手术后的常见并发症,表现为胸膜炎性胸痛、发热以及心包或胸腔积液。超声心动图和X线等传统诊断方法越来越多地得到CCT和CMR等先进成像方式的补充。这些工具能够更好地显示心包炎症和积液,有助于诊断并指导治疗。秋水仙碱和非甾体抗炎药仍然是治疗PPS最有效的药物,而皮质类固醇的作用仍不确定。生物治疗在复发性心包炎的管理方面已显示出有前景的结果。本综述借鉴我们机构的经验,提出了一种PPS诊断和管理的算法。多模态成像正在成为诊断和管理PPS的重要工具。它提高了诊断精度,为治疗策略提供依据,并提供预后见解。随着成像技术的进步,将这些方式整合到PPS护理中有可能改善患者的预后。

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