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作 者:沈洁[1] 贾慧惠[2] 孙凌[1] SHEN Jie;JIA Huihui;SUN Ling(Department of Cardiology,Children's Hospital of Soochow University,Suzhou,215003,China;不详)
机构地区:[1]苏州大学附属儿童医院心脏内科,江苏苏州215003 [2]苏州大学附属儿童医院影像科,江苏苏州215003
出 处:《中国实用儿科杂志》2025年第3期218-224,共7页Chinese Journal of Practical Pediatrics
摘 要:扩张型心肌病(dilated cardiomyopathy,DCM)是一种异质性强、病因复杂的心肌病。文章系统探讨了心脏磁共振(cardiovascular magnetic resonance,CMR)在儿童DCM中的应用价值,包括其在病因诊断、心肌评估、疗效监测和预后判断中的优势。DCM中CMR的应用序列包括基础序列如电影序列、黑血序列及钆对比剂延迟强化,其他常用序列和参数如T1 mapping、T2 mapping、心肌灌注序列和细胞外容积分数等。此外,CMR在右心室功能评估、心肌应变分析及左心室室内压力梯度测量中显示了显著价值。同时,文章总结了特殊基因型DCM的CMR表型特征,描述了CMR在儿童应用中的挑战及应对策略,为临床医师优化诊断和个性化治疗提供了有力支持。Dilated cardiomyopathy(DCM)is a highly heterogeneous cardiac disorder with complex etiologies.This review systematically explores the applications value of cardiovascular magnetic resonance(CMR)in pediatric DCM,including its advantages in etiological diagnosis,myocardial assessment,treatment effect monitoring,and prognostic judgment.Basic CMR sequences in DCM include cine sequences,black-blood sequences,and late gadolinium enhancement.Other sequences include T1 mapping,T2 mapping,extracellular volume fraction,and myocardial perfusion imaging.CMR also demonstrates significant value in evaluating right ventricular function,myocardial strain analysis,and intraventricular pressure gradient measurement.Meanwhile,this paper summarizes the CMR phenotypic features of specific genetic subtypes of DCM and describe challenges in applying CMR in pediatric patients and the strategies to deal with them,which provides robust support for clinicians to optimize diagnosis and personalized treatment approaches.
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