缺血性心肌纤维化的临床影像评估研究进展  

Advances in clinical imaging evaluation of ischemic myocardial fibrosis

作　　者：张玉莲 邓玮[1] ZHANG Yulian;DENG Wei(Department of General Practice,the Second Affiliated Hospital of Chongqing Medical University,Chongqing400000,China)

机构地区：[1]重庆医科大学附属第二医院全科医学科,重庆400000

出　　处：《中国当代医药》2023年第7期40-44,共5页China Modern Medicine

基　　金：重庆市科卫联合医学科研项目(2021MSXM094)。

摘　　要：冠心病是世界上主要的死亡原因,心肌纤维化是冠心病发展的必经阶段,继之发生心室重塑、心肌僵硬度增加、心律失常、心力衰竭等恶性心血管事件,是导致冠心病死亡率增加的重要因素。早期诊断心肌纤维化对冠心病的治疗、预后具有重要意义。目前国内外许多关于心肌纤维化的新锐研究结果表明,心脏影像学检查可无创评估心肌纤维化,避免了患者心肌活检的痛苦,在临床诊断和治疗中具有重要意义,现本文对近年来缺血性心肌纤维化的超声、核磁共振、计算机断层扫描以及分子成像的研究成果作一综述,讨论了心血管磁共振延迟钆增强的应用、心血管磁共振的量化方法、斑点追踪技术(STE)的应用、2D和3D STE优势对比、多种CT成像的应用、新型放射性示踪剂成像评估心肌纤维化。旨在为心肌纤维化的影像学评估提供理论和实践基础,推动国内相关技术的发展,解决心肌纤维化未满足的关键临床诊断需求。Coronary heart disease(CHD)is the main cause of death in the world.Myocardial fibrosis is an essential stage in the development of coronary heart disease,followed by ventricular remodeling,increased myocardial stiffness,arrhythmia,heart failure and other malignant cardiovascular events,which is an important factor leading to increased mortality of coronary heart disease.Early diagnosis of myocardial fibrosis is of great significance for the treatment and prognosis of coronary heart disease.For the diagnosis and dynamic monitoring of myocardial fibrosis,myocardial biopsy is the most reliable technology.Because it is invasive,it's difficult to be widely used.At present,many new researches indicate that cardiac imaging can noninvasively evaluate myocardial fibrosis,thus avoiding the pain of myocardial biopsy in patients,and is of great significance in clinical diagnosis and treatment.This paper reviews the research on ultrasound,nuclear magnetic resonance,computed tomography and molecular imaging of ischemic myocardial fibrosis in recent years,and discusses the application of cardiovascular magnetic resonance-late gadolinium enhancement,the quantitative method of cardiovascular magnetic resonance(CMR),the speckle tracking technique(STE),the comparison of 2D and 3D STE,the multiple CT imaging,and the new radiotracer imaging method for evaluating myocardial fibrosis.The aim is to provide theoretical and practical basis for imaging evaluation of myocardial fibrosis and promote the development of related technologies,to solve the key clinical diagnostic needs of myocardial fibrosis that unmet.

关 键 词：心肌纤维化 延迟钆增强 斑点追踪技术 计算机断层扫描 分子成像 

分 类 号：R541[医药卫生—心血管疾病]