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心脏磁共振成像在诊断和心血管风险评估中的应用

Cardiac Magnetic Resonance Imaging in Diagnostics and Cardiovascular Risk Assessment.

作者信息

Matusik Patrycja S, Mikrut Katarzyna, Bryll Amira, Popiela Tadeusz J, Matusik Paweł T

机构信息

Department of Radiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Kraków, Poland.

Department of Diagnostic Imaging, University Hospital, 30-688 Kraków, Poland.

出版信息

Diagnostics (Basel). 2025 Jan 14;15(2):178. doi: 10.3390/diagnostics15020178.

Abstract

Cardiac magnetic resonance (CMR) allows for analysis of cardiac function and myocardial tissue characterization. Increased left ventricular mass (LVM) is an independent predictor of cardiovascular events; however, the diagnosis of left ventricular hypertrophy and its prognostic value strongly depend on the LVM indexation method. Evaluation of the quantity and distribution of late gadolinium enhancement assists in clinical decisions on diagnosis, cardiovascular assessment, and interventions, including the placement of cardiac implantable electronic devices and the choice of an optimal procedural approach. Novel CMR techniques, such as T1 and T2 mapping, may be used for the longitudinal follow-up of myocardial fibrosis and myocardial edema or inflammation in different groups of patients, including patients with systemic sclerosis, myocarditis, cardiac sarcoidosis, amyloidosis, and both ischemic and non-ischemic cardiomyopathy, among others. Moreover, CMR tagging and feature tracking techniques might improve cardiovascular risk stratification in patients with different etiologies of left ventricular dysfunction. This review summarizes the knowledge about the current role of CMR in diagnostics and cardiovascular risk assessment to enable more personalized approach in clinical decision making.

摘要

心脏磁共振成像(CMR)可用于分析心脏功能和心肌组织特征。左心室质量(LVM)增加是心血管事件的独立预测因素;然而,左心室肥厚的诊断及其预后价值很大程度上取决于LVM的指数化方法。钆延迟强化的数量和分布评估有助于在诊断、心血管评估和干预措施(包括心脏植入式电子设备的植入以及最佳手术方法的选择)方面做出临床决策。新型CMR技术,如T1和T2映射,可用于对不同患者群体(包括系统性硬化症、心肌炎、心脏结节病、淀粉样变性以及缺血性和非缺血性心肌病等患者)的心肌纤维化、心肌水肿或炎症进行纵向随访。此外,CMR标记和特征跟踪技术可能会改善不同病因的左心室功能障碍患者的心血管风险分层。本综述总结了关于CMR在诊断和心血管风险评估中当前作用的知识,以便在临床决策中采用更个性化的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9804/11764230/bf3019f48e1f/diagnostics-15-00178-g001.jpg

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