心脏磁共振在糖尿病心肌病亚临床阶段中的研究进展  

Advances in research on the application of cardiac magnetic resonance imaging in the subclinical stage of diabetic cardiomyopathy

作　　者：吴永顺 包梦圆 张林鑫 邢艳 WU Yongshun;BAO Mengyuan;ZHANG Linxin;XING Yan(Imaging Center,First Affiliated Hospital of Xinjiang Medica University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院影像中心,乌鲁木齐830011

出　　处：《磁共振成像》2025年第4期168-173,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题项目(编号:SKL-HIDCA-2023-10);“天山英才”医药卫生高层次人才培养计划(编号:TSYC202301B009)。

摘　　要：糖尿病心肌病(diabetic cardiomyopathy,DCM)作为糖尿病(diabetes mellitus,DM)常见并发症之一,其早期表现为无症状性心肌损伤和功能异常,而DCM早期诊断和干预对预后至关重要。由于传统影像学技术对亚临床心肌病变的敏感性不足,近年来多参数心脏磁共振(cardiac magnetic resonance,CMR)因其无创性、高分辨率及多功能成像能力,成为早期识别DCM亚临床阶段的重要工具,在近期的指南和专家共识中得到认可,相关研究不断推陈出新。本文将从心肌代谢异常、微循环功能障碍、心肌纤维化及心肌应变等方面,系统阐述CMR在DCM亚临床期病变诊断应用中的研究进展,分析CMR应用于DCM亚临床期诊断的优势和挑战,为未来的临床诊疗和研究方向提供参考。Diabetic cardiomyopathy(DCM),as one of the common complications of diabetes mellitus(DM),manifests early as asymptomatic myocardial injury and functional abnormalities.The early diagnosis and intervention of DCM are crucial for prognosis.Due to the insufficient sensitivity of traditional imaging techniques in detecting subclinical myocardial lesions,multiparametric cardiac magnetic resonance(CMR) has emerged as a significant tool for early identification of the subclinical stage of DCM in recent years.This is attributed to its non-invasiveness,high resolution,and multifunctional imaging capabilities.Its importance has been recognized in recent guidelines and expert consensuses,and relevant research continues to evolve.This article systematically reviews the research progress of CMR in the diagnosis of subclinical lesions in DCM,focusing on myocardial metabolic abnormalities,microcirculation dysfunction,myocardial fibrosis,and myocardial strain.Furthermore,it analyzes the advantages and challenges of applying CMR in the subclinical diagnosis of DCM,providing a reference for future clinical diagnosis,treatment,and research directions。

关 键 词：糖尿病心肌病 心脏磁共振 磁共振波谱 心肌纤维化 心肌应变 

分 类 号：R445.2[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]