2018年版《非缺血性心肌炎症心血管磁共振检查专家共识》解读

Interpretation of the 2018 edition of Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation:Expert Recommendations

2009年美国心脏病学会杂志(JACC)发布了心肌炎性疾病的心血管磁共振(CMR)共识标准(路易斯湖标准),并被广泛应用于临床和研究领域。然而,CMR仅用信号强度描述组织特征显得有些不足,2018年JACC专家小组为疑似急性或活动性心肌病患者的CMR诊断标准(路易斯湖标准)的更新制定了共识,其中包括选择使用参数mapping技术。CMR显示心肌水肿、充血和毛细血管渗透、坏死和纤维化等,与其他炎性心肌损伤指标结合,将为心肌炎症提供强有力的证据,且特异性增加。该共识更新希望进一步提高CMR对心肌炎症检测的准确性。

In 2009,the Consensus Criteria for Cardiovascular Magnetic Resonance in Myocarditis-A JACC White Paper,was published and used extensively in both clinical and research areas.However,CMR tissue characteriza⁃tion using signal intensities has some shortcomings.The Journal of the American College of Cardiology(JACC)Sci⁃entific Expert Panel provides consensus recommendations for an update of the CMR diagnostic criteria for myocardial inflammation in patients with suspected acute or active myocardial inflammation(Lake Louise Criteria)that includes options using parametric mapping techniques.The CMR provides strong evidence for myocardial inflammation,by demonstrating the combination of myocardial edema,hyperemia and capillary leak,necrosis and fibrosis with other CMR markers of inflammatory myocardial injury.The update is expected to improve the diagnostic accuracy of CMR further in detecting myocardial inflammation.