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急性心肌炎患儿的基线和随访心脏磁共振成像结果以及与延迟钆增强相关的因素

Baseline and Follow-Up Cardiac Magnetic Resonance Imaging Findings in Children with Acute Myocarditis and Factors Associated with Late Gadolinium Enhancement.

作者信息

Yukcu Bekir, Aydemir Merve Maze, Balci Mehmet, Kanyilmaz Mehmet, Turkvatan Aysel, Gokalp Selman, Guzeltas Alper, Atik Sezen Ugan

机构信息

Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul 34303, Turkey.

Department of Radiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul 34303, Turkey.

出版信息

J Clin Med. 2024 Dec 31;14(1):189. doi: 10.3390/jcm14010189.

Abstract

: Cardiac magnetic resonance (CMR) plays a central role in the diagnosis and follow-up of acute myocarditis (AM). In this study, we aimed to evaluate baseline and follow-up CMR findings and associated factors in children with AM. : A retrospective analysis of CMR in pediatric patients with clinical presentations suggestive of myocarditis was performed. Patients' demographic characteristics, clinical data, and diagnostic test results, as well as CMR imaging results, were evaluated. : All 28 pediatric patients with acute myocarditis included in this study had late gadolinium enhancement (LGE) on initial CMR imaging. Additionally, 14 (50%) patients had increased extracellular volume (ECV), 4 (50%) patients had focal high-intensity areas on T2 STIR images, 15 (53.6%) patients had increased T1 relaxation time, and 17 (60.7%) patients had increased T2 relaxation time. At a median follow-up CMR of 6 months, 24 (85.7%) patients had LGE, 5 (17.9%) patients had increased ECV, and 7 (25%) patients had increased T1 relaxation time, while other parameters showed complete recovery. Baseline troponin and CRP levels, T1 relaxation time, T2 relaxation time, and increased ECV were found to be factors associated with the resolution of LGE. : Baseline troponin and CRP levels, as well as T1 relaxation time, T2 relaxation time, and increased ECV, were effective parameters that seemed to predict the resolution of LGE. Larger and multicenter experiences would confirm these hypotheses.

摘要

心脏磁共振成像(CMR)在急性心肌炎(AM)的诊断及随访中发挥着核心作用。在本研究中,我们旨在评估患AM儿童的CMR基线及随访结果和相关因素。

对临床表现提示心肌炎的儿科患者的CMR进行回顾性分析。评估了患者的人口统计学特征、临床数据、诊断检查结果以及CMR成像结果。

本研究纳入的28例急性心肌炎儿科患者在初次CMR成像时均有延迟钆增强(LGE)表现。此外,14例(50%)患者细胞外容积(ECV)增加,4例(50%)患者在T2 STIR图像上有局灶性高强度区域,15例(53.6%)患者T1弛豫时间延长,17例(60.7%)患者T2弛豫时间延长。在中位随访6个月的CMR检查中,24例(85.7%)患者有LGE,5例(17.9%)患者ECV增加,7例(25%)患者T1弛豫时间延长,而其他参数显示完全恢复。发现基线肌钙蛋白和CRP水平、T1弛豫时间、T2弛豫时间以及ECV增加是与LGE消退相关的因素。

基线肌钙蛋白和CRP水平以及T1弛豫时间、T2弛豫时间和ECV增加是似乎可预测LGE消退的有效参数。更大规模和多中心的研究经验将证实这些假设。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a09/11721544/ea1b881c6d44/jcm-14-00189-g001.jpg

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