T1、T2 mapping成像技术评价蒽环类药物所致心脏毒性的研究进展

The research progress of T1 and T2 mapping in the evaluation of anthracycline induced cardiotoxicity

随着现代医疗手段的进步,肿瘤患者的生存期逐渐延长,癌症患者的远期生存质量越来越得到重视。蒽环类抗肿瘤药物应用于临床已达半世纪之久,在血液系统肿瘤及乳腺癌的治疗上目前仍然有着不可取代的地位。然而其所导致的心脏毒性亦对肿瘤患者的远期生存构成严重威胁。心脏磁共振(cardiac magnetic resonance,CMR)因其安全性高、具有可重复性等优点,已经成为评价心功能的金标准。除了CMR的常规指标外,一些尚未纳入欧洲心脏病学会(European society of cardiology,ESC)指南的新兴指标,如T1 mapping、T2 mapping等,更是可以从数值上直观、定量的评价出心肌细胞水肿及纤维化的程度,以便临床更精准的用药指导,这些新兴技术手段已经成为研究一大热点。本文现对T1、T2 mapping评价蒽环类药物所致心脏毒性的研究进展做一综述。

With the progress of modern medical means,the survival period of cancer patients is gradually extended,and the long-term quality of life of cancer patients is getting more and more attention.Anthracycline anti-tumor drugs have been used in clinic for half a century,and they still play an irreplaceable role in the treatment of blood system tumors and breast cancer.However,the cardiotoxicity caused by it also poses a serious threat to the long-term survival of cancer patients.Cardiac magnetic resonance(CMR)has become the gold standard for evaluating cardiac function because of its high safety and repeatability.In addition to the conventional indicators of CMR,some emerging indicators that have not been included in ESC guidelines,such as T1 mapping,T2 mapping,etc.,can directly and quantitatively evaluate the degree of myocardial cell edema and fibrosis from the numerical point of view,and give more accurate clinical medication guidance.These emerging technical means have become a research hotspot.In this paper,T1 and T2 mapping are reviewed to evaluate the cardiotoxicity induced by anthracyclines.