心脏核磁共振检查在临床实践中的实效性研究

Clinical Application of Cardiac Magnetic Resonance Imaging in a Tertiary Referral Hospital in China

目的探讨心脏核磁共振(CMR)在临床诊疗过程中的应用现状。方法连续纳入344例符合CMR检查指征的患者,收集患者CMR图像及诊断描述,并利用CMR图像对心脏结构、功能指标及钆延迟强化(LGE)等指标进行测量及分析。结果本组资料中,因心力衰竭和心肌病进行CMR检查的患者最多,共有164例,占患者总数的47.7%,其次是冠状动脉疾病(79例,23.0%)和室性心律失常(65例,18.9%)。进一步对图像质量清晰的319例(92.7%)患者的心肌结构及功能进行定量分析,发现208例(65.2%)患者存在左心室扩大,46例(14.4%)患者存在右心室扩大。并且197例(57.3%)患者通过CMR检查证实了最初诊断,73例(21.2%)患者通过CMR检查修正了最初诊断,另外仍有74例(21.5%)患者不能仅依靠CMR检查明确诊断。结论患者进行CMR检查的适应征为评估患者的心脏结构和功能。该检查还可辅助鉴别其他影像学检查未能识别的心脏异常表现,从而为患者明确诊断、制定治疗方案以及判断预后提供更多有价值的信息。

Objective To review clinical application of cardiac magnetic resonace（CMR）imaging in a tertiary hospital.Methods A total of 344 medical records were reviewed in relation to the use of CMR imaging over one year period in a tertiary hospital in China.Data regarding indications for CMR imaging,cardiac structure and function,late gadolinium enhancement（LGE）,and diagnoses made from CMR imaging were extracted and examined.Results Detection of heart failure and cardiomyopathies was the most common reason for CMR imaging requests〔164（47.7%）of requests〕,which was followed by diagnoses of coronary artery disease〔79（23.0%）of requests〕and ventricular arrhythmia〔65（18.9%）of requests〕.Quantitative analyses were made in 319（92.7%）cases,with 208（65.2%）patients being identified with ventricular dilatation and 46（14.4%）patients being identified with right ventricular dilatation.Apart from 74（21.5%）cases for which a confirmed diagnosis could not be obtained,CMR imaging assessment corrected 21.2%（73patients）and confirmed 57.3%（197patients）of initial referral diagnoses.Conclusion CMR imaging is mainly used for structural and functional assessments of hearts,which can help identify abnormalities that are not detected by other imaging modalities.It can provide incremental diagnostic,therapeutic,and prognostic information.