磁共振路易斯湖诊断标准及特征追踪技术在心肌炎诊断中的应用进展

Current application of cardiac MRI in diagnosing myocarditis

心肌炎是一种心肌炎症性疾病,还是导致年轻人急性心力衰竭、猝死和扩张型心肌病的重要原因。心肌炎的临床症状及辅助检查结果与急性冠脉综合征的表现极其相似,常规检查鉴别诊断往往困难。虽然诊断心肌炎的"金标准"是心肌活检,但因有创、灵敏度差及病灶的局限性而限制其临床应用。心脏磁共振(CMR)"一站式"检查,不但能够了解及评估心脏结构和功能;还能直观地观察到心肌组织的病理改变(包括水肿、毛细血管渗出、细胞坏死及纤维化等)及心肌应变。随着影像技术的发展,路易斯湖诊断标准结合磁共振特征追踪技术诊断心肌炎特异性更高,评估病情变化及疗效更准确。故该文就磁共振路易斯湖诊断标准及特征追踪技术在心肌炎诊断中的应用进行综述。

Myocarditis is an inflammatory disease of myocardium,which also is an important cause of acute heart failure,sudden death and dilated cardiomyopathy in young people.The clinical symptoms of myocarditis and its auxiliary examination results are extremely similar with acute coronary syndrome performance,routine check for making differential diagnosis is often difficult.Although the"gold standard"for diagnosis of myocarditis is the myocardial biopsy,but its clinical application is limited due to its invasive,less sensitive and lesion localized.Cardiac magnetic resonance imaging(CMR)"one-stop"examination can not only understand and evaluate cardiac structure and function,the pathological changes of myocardial tissue(including edema,capillaries,cell necrosis and fibrosis)and myocardial strain are also well directly observed.With the development of imaging technology,Lake Louise Consensus Criteria combined with Feature tracking have higher specificity for diagnosis of myocarditis,with more accurate in assessment of the changes and in curative effect of the disease.This paper reviews the application of cardiac magnetic resonance Lake Louise Consensus Criteria and Feature tracking technology in myocarditis.