心脏磁共振评价恶性肿瘤免疫检查点抑制剂心脏系统免疫相关不良反应中国专家共识  

Consensus of Chinese experts on cardiovascular MRI in evaluating immune-related adverse cardiac events associated with immune checkpoint inhibitors for malignant tumors

作　　者：中华医学会放射学分会分子影像学组 中华医学会放射学分会磁共振学组 中华医学会放射学分会心胸学组 《磁共振成像》编委会 孙洪赞[2] 居胜红[3] 陈伟 郜发宝 李小虎 李勇刚[7] 史河水[8] 王冠[9] 王星皓 温志波[11] 徐臣 袁正 Molecular Imaging Group of Chinese Society of Radiology of Chinese Medical Association;MRI Group of Chinese Society ofRadiology Chinese Medical Association;Cardiac-Chest Group of Chinese Society of Radiology Chinese Medical Association;EditorialBoard of Chinese Journal of Magnetic Resonance Imaging;SUN H Z;JU S H(不详;Department of Radiology,Shengjing Hospital Affiliated to China Medical University,Shenyang 110004,China;Department of Radiology,Zhongda Hospital Affiliated to Southeast University,Nanjing 210009,China)

机构地区：[1]不详 [2]中国医科大学附属盛京医院放射科,沈阳110004 [3]东南大学附属中大医院放射科,南京210009 [4]昆明医科大学第一附属医院 [5]四川大学华西医院 [6]安徽医科大学附属第一医院 [7]苏州大学附属第一医院 [8]华中科技大学同济医学院附属协和医院 [9]中国医科大学附属第一医院 [10]首都医科大学附属北京友谊医院 [11]南方医科大学珠江医院 [12]中国医科大学附属盛京医院 [13]上海交通大学医学院附属第九人民医院

出　　处：《磁共振成像》2024年第12期10-18,共9页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:82220108007、82271989、92359304、82330060、92059202)。

摘　　要：免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)作为恶性肿瘤的免疫治疗药物,在多种实体肿瘤治疗中显示出显著疗效。然而,ICIs也可能引发免疫相关不良事件(immune-related adverse events,irAEs),包括心血管毒性,虽然发病率低,但死亡率高。随着ICIs的广泛应用,心血管irAEs的病例也在增加,需要影像和临床医生的关注。MRI作为高敏感度和高分辨率的影像学检查手段,在检测和评估心血管irAEs中发挥着关键作用。早期通过MRI对心血管irAEs进行诊断和评估对于患者的治疗和预后至关重要。然而,国内在此领域尚缺乏统一的规范化共识,可能导致诊断和治疗方案的差异。为了解决这一问题,中华医学会放射学分会分子影像学组、磁共振学组、心胸学组与《磁共振成像》编委会合作,制订了一套针对ICIs引起的心血管系统irAEs的MRI检查方案和诊断报告的共识。这一共识旨在为影像和临床医生提供科学依据,推动MRI技术在心血管系统irAEs诊断中的应用。In recent years,cancer immunotherapy,particularly immune checkpoint inhibitors(ICIs),has emerged as a significant breakthrough in the treatment of malignant tumors,substantially improving patient outcomes.However,the potential of ICIs to trigger immune-related adverse events(irAEs),including cardiovascular toxicity,poses a significant challenge to cancer immunotherapy.Although the incidence is low,the mortality rate is high.With the increasing use of ICIs,cases of cardiovascular irAEs are on the rise,necessitating the attention of both imaging and clinical physicians.MRI,with its high sensitivity and resolution,plays a pivotal role in the detection and assessment of cardiovascular irAEs.Early diagnosis and evaluation of cardiovascular irAEs through MRI are crucial for patient treatment and prognosis.However,there is currently a lack of unified standardized consensus in China regarding MRI examination and diagnosis of cardiovascular irAEs caused by ICIs.To address this issue,the Molecular Imaging Group,Magnetic Resonance Group,and Cardiothoracic Group of the Radiology Branch of the Chinese Medical Association,in collaboration with the Editorial Board of Chinese Journal of Magnetic Resonance Imaging,have developed a consensus on MRI examination protocols and diagnostic reporting for cardiovascular system irAEs induced by ICIs.This consensus aims to provide a scientific basis for imaging and clinical physicians and to promote the application of MRI technology in the diagnosis of cardiovascular system irAEs.

关 键 词：磁共振成像 免疫检查点抑制剂 心脏免疫相关不良反应 临床应用 专家共识 

分 类 号：R445.2[医药卫生—影像医学与核医学] R73[医药卫生—诊断学]