磁共振路易斯湖诊断标准及特征追踪技术在心肌炎诊断中的应用进展
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摘要
心肌炎是一种心肌炎症性疾病,还是导致年轻人急性心力衰竭、猝死和扩张型心肌病的重要原因。心肌炎的临床症状及辅助检查结果与急性冠脉综合征的表现极其相似,常规检查鉴别诊断往往困难。虽然诊断心肌炎的"金标准"是心肌活检,但因有创、灵敏度差及病灶的局限性而限制其临床应用。心脏磁共振(CMR)"一站式"检查,不但能够了解及评估心脏结构和功能;还能直观地观察到心肌组织的病理改变(包括水肿、毛细血管渗出、细胞坏死及纤维化等)及心肌应变。随着影像技术的发展,路易斯湖诊断标准结合磁共振特征追踪技术诊断心肌炎特异性更高,评估病情变化及疗效更准确。故该文就磁共振路易斯湖诊断标准及特征追踪技术在心肌炎诊断中的应用进行综述。
Myocarditis is an inflammatory disease of myocardium,which also is an important cause of acute heart failure,sudden death and dilated cardiomyopathy in young people. The clinical symptoms of myocarditis and its auxiliary examination results are extremely similar with acute coronary syndrome performance,routine check for making differential diagnosis is often difficult. Although the "gold standard" for diagnosis of myocarditis is the myocardial biopsy,but its clinical application is limited due to its invasive,less sensitive and lesion localized.Cardiac magnetic resonance imaging(CMR) "one-stop" examination can not only understand and evaluate cardiac structure and function,the pathological changes of myocardial tissue(including edema,capillaries,cell necrosis and fibrosis) and myocardial strain are also well directly observed. With the development of imaging technology,Lake Louise Consensus Criteria combined with Feature tracking have higher specificity for diagnosis of myocarditis,with more accurate in assessment of the changes and in curative effect of the disease. This paper reviews the application of cardiac magnetic resonance Lake Louise Consensus Criteria and Feature tracking technology in myocarditis.
Myocarditis is an inflammatory disease of myocardium,which also is an important cause of acute heart failure,sudden death and dilated cardiomyopathy in young people. The clinical symptoms of myocarditis and its auxiliary examination results are extremely similar with acute coronary syndrome performance,routine check for making differential diagnosis is often difficult. Although the "gold standard" for diagnosis of myocarditis is the myocardial biopsy,but its clinical application is limited due to its invasive,less sensitive and lesion localized.Cardiac magnetic resonance imaging(CMR) "one-stop" examination can not only understand and evaluate cardiac structure and function,the pathological changes of myocardial tissue(including edema,capillaries,cell necrosis and fibrosis) and myocardial strain are also well directly observed. With the development of imaging technology,Lake Louise Consensus Criteria combined with Feature tracking have higher specificity for diagnosis of myocarditis,with more accurate in assessment of the changes and in curative effect of the disease. This paper reviews the application of cardiac magnetic resonance Lake Louise Consensus Criteria and Feature tracking technology in myocarditis.
引文
[1]KOTANIDIS CP,BAZMPANI MA,HAIDICH AB,et al.Diagnostic accuracy of cardiovascular magnetic resonance in acute myocarditis:A systematic review and meta-analysis[J].JACCCardiovasc Imaging,2018,17(9):31182-31188.
[2]TIPOO SULTAN FA,ADNAN G.Myocarditis mimicking acute coronary syndrome-the role of cardiac magnetic resonance imaging in the diagnosis[J].J Pak Med Assoc,2018,68(3):477-479.
[3]BIESBROEK PS,BEEK AM,GERMANS T,et al.Diagnosis of myocarditis:current state and future perspectives[J].Int J Cardiol,2015,191(2):211-219.
[4]FRIEDRICH MG,SECHTEM U,SCHULZ-MENGER J,et al.Cardiovascular magnetic resonance in myocarditis:a JACC White Paper[J].J Am Coll Cardiol,2009,53(17):1475-1487.
[5]CAFORIO ALP,PANKUWEIT S,ARBUSTINI E,et al.Current state of knowledge on aetiology,diagnosis,management,and therapy of myocarditis:a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases[J].Eur Heart J,2013,34(33):2636-2648.
[6]BIESBROEK PS,HIRSCH A,ZWEERINK A,et al.Additional diagnostic value of CMR to the European Society of Cardiology(ESC)position statement criteria in a large clinical population of patients with suspected myocarditis[J].Eur Heart J Cardiovas Imaging,2017,32(7):1093-1101.
[7]RODRIGUES P,JOSHI A,WILLIAMS H,et al.Diagnosis and prognosis in sudden cardiac arrest survivors without coronary artery disease:Utility of a clinical approach using cardiac magnetic resonance imaging[J].Circ Cardiovasc Imaging,2017,10(12):97-105.
[8]GAIKWAD N,BUTLER T,MAXWELL R,et al.Late gadolinium enhancement does occur in Tako-tsubo cardiomyopathy-A quantitative cardiac magnetic resonance and speckle tracking strain study[J].Int J Cardiol Heart Vasc,2016,12(3):68-74.
[9]WEI S,FU J,CHEN L,et al.Performance of cardiac magnetic resonance imaging for diagnosis of myocarditis compared with endomyocardial biopsy:A meta-analysis3[J].Med Sci Monit,2017(23):3687-3696.
[10]冉华,王正中,何艺,等.心脏磁共振成像对急性冠状动脉综合征表现为主的病毒性心肌炎的诊断价值[J].磁共振成像,2017,8(8):578-582.
[11]OUYANG HC,OUYANG FC,MAI LL,et al.Predictive value of cardiac magnetic resonance-derived parameters on the improvement of left ventricular function in patients with acute viral myocarditis[J].Zhonghua Xinxueguanbing Zazhi,2017,45(9):758-764.
[12]HINOJAR R,FOOTE L,UCAR EA,et al.Native T1 in discrimination of acute and convalescent stages in patients with clinical diagnosis of myocarditis:A proposed diagnostic algorithm using CMR[J].J Am Coll Cardiol Img,2015,8(1):37-46.
[13]DALL'ARMELLINA E,PIECHNIK SK,FERREIRA VM,et al.Cardiovascular magnetic resonance by non contrast T1-mapping allows assessmentof severity of injury in acute myocardial infarction[J].J Cardio-vasc Magn Reson,2012,6(1):14,15.
[14]MAVROGENI S,APOSTOLOU D,ARGYRIOU P,et al.T1 and T2 mapping in cardiology:"mapping the obscure object of desire"[J].Cardiology,2017,138(4):207-217.
[15]MAVROGENI SI,MARKOUSIS-MAVROGENIS G,KOLOVOUG.Ferumoxytol in acute myocarditis:keep your head in the clouds and your feet on the earth'[J].Heart,2018,104(4):278-279.
[16]PUNTMANN VO,ZEIHER AM,NAGEL E.T1 and T2 mapping in myocarditis:seeing beyond the horizon of Lake Louise criteria and histopathology[J].Expert Rev Cardiovasc Ther,2018,16(5):319-330.
[17]VON KNOBELSDORFF-BRENKENHOFF F,SCHüLER J,DOGANGüZEL S,et al.Detection and monitoring of acute myocarditis applying quantitative cardio-vascular magnetic resonance[J].Circ Cardiovasc Imaging,2017,10:e005242.
[18]GRANI C,EICHHORN C,BIERE L,MURTHY VL,et al.Prognostic value of cardiac magnetic resonance tissue characterization in risk stratifying patients with suspected myocarditis[J].J Am Coll Cardiol,2017,70(16):1964-1976.
[19]AQUARO GD,PERFETTI M,CAMASTRA G,et al.Cardiac magnetic resonance working group of the italian society of cardiology.Cardiac MR with late gadolinium enhancement in acute myocarditis with preserved systolic function:ITAMYStudy[J].J Am Coll Cardiol,2017,70(16):1977-1987.
[20]LURZ P,LUECKE C,EITEL I,et al.Comprehensive cardiac magnetic resonance imaging in Patients with suspected myocarditis:the Myo Racer-trial[J].J Am Coll Cardiol,2016,67(15):1800-1811.
[21]BAEβLER B,SCHAARSCHMIDT F,DICK A,et al.Diagnostic implications of magnetic resonance feature tracking derived myocardial strain parameters in acute myocarditis[J].Eur JRadiol,2016,85(1):218-227.
[22]BAEβLER B,TREUTLEIN M,SCHAARSCHMIDT F,et al.Anovel multiparametric imaging approach to acute myocarditis using T2-mapping and CMR feature tracking[J].J Cardiovasc Magn Reson,2017,19(1):71.
[23]LUETKENS JA,SCHLESINGER-IRSCH U,KUETTING DL,et al.Feature-tracking myocardial strain analysis in acute myocarditis:diagnostic value and association with myocardial oedema[J].Eur Radiol,2017,27(11):4661-4671.
[24]KASNER M,ALEKSANDROV A,ESCHER F,et al.Multimodality imaging approach in the diagnosis of chronic myocarditis with preserved left ventricular ejection fraction(MCp EF):The role of 2D speckle-tracking echocardiography[J].Int J Cardiol,2017,243:374-378.
[25]ANDRE F,STOCK FT,RIFFEL J,et al.Incremental value of cardiac deformation analysis in acute myocarditis:a cardiovascular magnetic resonance imaging study[J].Int J Cardiovasc Imaging,2016,32(7):1093-1101.
[26]KOSTAKOU PM,KOSTOPOULOS VS,TRYFOU ES,et al.Subclinical left ventricular dysfunction and correlation with regional strain analysis in myocarditis with normal ejection fraction.A new diagnostic criterion[J].Int J Cardiol,2018,259(2):116-121.
[27]DICK A,SCHMIDT B,MICHELS G,et al.Left and right atrial feature tracking in acute myocarditis:A feasibility study[J].Eur J Radiol,2017,89(1):72-80.
[28]LEE JW,JEONG YJ,LEE G,et al.Predictive value of cardiac magnetic resonance imaging-derived myocardial strain for poor outcomes in patients with acute myocarditis[J].Korean J Radiol,2017,18(4):643-654.
[29]WISOTZKEY BL,SORIANO BD,ALBERS EL,et al.Diagnostic role of strain imaging in atypical myocarditis by echocardiography and cardiac MRI[J].Pediatr Radiol,2018,48(6):835-842.
[30]LEITMAN M,VERED Z,TYOMKIN V,et al.Speckle tracking imaging in inflammatory heart diseases[J].Int J Cardiovasc Imaging,2018,34(5):787-792.
[2]TIPOO SULTAN FA,ADNAN G.Myocarditis mimicking acute coronary syndrome-the role of cardiac magnetic resonance imaging in the diagnosis[J].J Pak Med Assoc,2018,68(3):477-479.
[3]BIESBROEK PS,BEEK AM,GERMANS T,et al.Diagnosis of myocarditis:current state and future perspectives[J].Int J Cardiol,2015,191(2):211-219.
[4]FRIEDRICH MG,SECHTEM U,SCHULZ-MENGER J,et al.Cardiovascular magnetic resonance in myocarditis:a JACC White Paper[J].J Am Coll Cardiol,2009,53(17):1475-1487.
[5]CAFORIO ALP,PANKUWEIT S,ARBUSTINI E,et al.Current state of knowledge on aetiology,diagnosis,management,and therapy of myocarditis:a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases[J].Eur Heart J,2013,34(33):2636-2648.
[6]BIESBROEK PS,HIRSCH A,ZWEERINK A,et al.Additional diagnostic value of CMR to the European Society of Cardiology(ESC)position statement criteria in a large clinical population of patients with suspected myocarditis[J].Eur Heart J Cardiovas Imaging,2017,32(7):1093-1101.
[7]RODRIGUES P,JOSHI A,WILLIAMS H,et al.Diagnosis and prognosis in sudden cardiac arrest survivors without coronary artery disease:Utility of a clinical approach using cardiac magnetic resonance imaging[J].Circ Cardiovasc Imaging,2017,10(12):97-105.
[8]GAIKWAD N,BUTLER T,MAXWELL R,et al.Late gadolinium enhancement does occur in Tako-tsubo cardiomyopathy-A quantitative cardiac magnetic resonance and speckle tracking strain study[J].Int J Cardiol Heart Vasc,2016,12(3):68-74.
[9]WEI S,FU J,CHEN L,et al.Performance of cardiac magnetic resonance imaging for diagnosis of myocarditis compared with endomyocardial biopsy:A meta-analysis3[J].Med Sci Monit,2017(23):3687-3696.
[10]冉华,王正中,何艺,等.心脏磁共振成像对急性冠状动脉综合征表现为主的病毒性心肌炎的诊断价值[J].磁共振成像,2017,8(8):578-582.
[11]OUYANG HC,OUYANG FC,MAI LL,et al.Predictive value of cardiac magnetic resonance-derived parameters on the improvement of left ventricular function in patients with acute viral myocarditis[J].Zhonghua Xinxueguanbing Zazhi,2017,45(9):758-764.
[12]HINOJAR R,FOOTE L,UCAR EA,et al.Native T1 in discrimination of acute and convalescent stages in patients with clinical diagnosis of myocarditis:A proposed diagnostic algorithm using CMR[J].J Am Coll Cardiol Img,2015,8(1):37-46.
[13]DALL'ARMELLINA E,PIECHNIK SK,FERREIRA VM,et al.Cardiovascular magnetic resonance by non contrast T1-mapping allows assessmentof severity of injury in acute myocardial infarction[J].J Cardio-vasc Magn Reson,2012,6(1):14,15.
[14]MAVROGENI S,APOSTOLOU D,ARGYRIOU P,et al.T1 and T2 mapping in cardiology:"mapping the obscure object of desire"[J].Cardiology,2017,138(4):207-217.
[15]MAVROGENI SI,MARKOUSIS-MAVROGENIS G,KOLOVOUG.Ferumoxytol in acute myocarditis:keep your head in the clouds and your feet on the earth'[J].Heart,2018,104(4):278-279.
[16]PUNTMANN VO,ZEIHER AM,NAGEL E.T1 and T2 mapping in myocarditis:seeing beyond the horizon of Lake Louise criteria and histopathology[J].Expert Rev Cardiovasc Ther,2018,16(5):319-330.
[17]VON KNOBELSDORFF-BRENKENHOFF F,SCHüLER J,DOGANGüZEL S,et al.Detection and monitoring of acute myocarditis applying quantitative cardio-vascular magnetic resonance[J].Circ Cardiovasc Imaging,2017,10:e005242.
[18]GRANI C,EICHHORN C,BIERE L,MURTHY VL,et al.Prognostic value of cardiac magnetic resonance tissue characterization in risk stratifying patients with suspected myocarditis[J].J Am Coll Cardiol,2017,70(16):1964-1976.
[19]AQUARO GD,PERFETTI M,CAMASTRA G,et al.Cardiac magnetic resonance working group of the italian society of cardiology.Cardiac MR with late gadolinium enhancement in acute myocarditis with preserved systolic function:ITAMYStudy[J].J Am Coll Cardiol,2017,70(16):1977-1987.
[20]LURZ P,LUECKE C,EITEL I,et al.Comprehensive cardiac magnetic resonance imaging in Patients with suspected myocarditis:the Myo Racer-trial[J].J Am Coll Cardiol,2016,67(15):1800-1811.
[21]BAEβLER B,SCHAARSCHMIDT F,DICK A,et al.Diagnostic implications of magnetic resonance feature tracking derived myocardial strain parameters in acute myocarditis[J].Eur JRadiol,2016,85(1):218-227.
[22]BAEβLER B,TREUTLEIN M,SCHAARSCHMIDT F,et al.Anovel multiparametric imaging approach to acute myocarditis using T2-mapping and CMR feature tracking[J].J Cardiovasc Magn Reson,2017,19(1):71.
[23]LUETKENS JA,SCHLESINGER-IRSCH U,KUETTING DL,et al.Feature-tracking myocardial strain analysis in acute myocarditis:diagnostic value and association with myocardial oedema[J].Eur Radiol,2017,27(11):4661-4671.
[24]KASNER M,ALEKSANDROV A,ESCHER F,et al.Multimodality imaging approach in the diagnosis of chronic myocarditis with preserved left ventricular ejection fraction(MCp EF):The role of 2D speckle-tracking echocardiography[J].Int J Cardiol,2017,243:374-378.
[25]ANDRE F,STOCK FT,RIFFEL J,et al.Incremental value of cardiac deformation analysis in acute myocarditis:a cardiovascular magnetic resonance imaging study[J].Int J Cardiovasc Imaging,2016,32(7):1093-1101.
[26]KOSTAKOU PM,KOSTOPOULOS VS,TRYFOU ES,et al.Subclinical left ventricular dysfunction and correlation with regional strain analysis in myocarditis with normal ejection fraction.A new diagnostic criterion[J].Int J Cardiol,2018,259(2):116-121.
[27]DICK A,SCHMIDT B,MICHELS G,et al.Left and right atrial feature tracking in acute myocarditis:A feasibility study[J].Eur J Radiol,2017,89(1):72-80.
[28]LEE JW,JEONG YJ,LEE G,et al.Predictive value of cardiac magnetic resonance imaging-derived myocardial strain for poor outcomes in patients with acute myocarditis[J].Korean J Radiol,2017,18(4):643-654.
[29]WISOTZKEY BL,SORIANO BD,ALBERS EL,et al.Diagnostic role of strain imaging in atypical myocarditis by echocardiography and cardiac MRI[J].Pediatr Radiol,2018,48(6):835-842.
[30]LEITMAN M,VERED Z,TYOMKIN V,et al.Speckle tracking imaging in inflammatory heart diseases[J].Int J Cardiovasc Imaging,2018,34(5):787-792.
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