无创性多模态影像学在缩窄性心包炎的临床价值及研究进展

Clinical value and research progress of noninvasive multimodality imaging in constrictive pericarditis

缩窄性心包炎其主要特征是心包顺应性减低,心室充盈受损,从而导致舒张性心力衰竭。通常与限制性心肌病具有相同的血流动力学特征。但其治疗方法和预后不同。临床上准确诊断和及时干预治疗对于改善患者预后至关重要。无创性的多模态影像学检查在缩窄性心包炎的诊断及鉴别诊断中有十分重要价值。超声心动图检查主要优势为其诊断提供了可靠的血流动力学数据,常作为临床一线筛查手段;计算机断层扫描或心脏磁共振可以提供重要辅助诊断。本文主要就无创性多模态影像学在缩窄性心包炎的诊断,评估缩窄性心包炎患者心包解剖和血流动力学及其与限制性心肌病鉴别诊断做一简要综述。

Constrictive pericarditis is characterized by incompliance of the pericardium and impairment of ventricular filling,leading to diastolic heart failure.It usually has the same hemodynamic characteristics as restrictive cardiomyopathy.However,they have a different treatment and prognosis.Correct diagnosis and timely clinical management are crucial to improve the prognosis of patients.Noninvasive multimodality imaging techniques are very important in the diagnosis and differential diagnosis of constrictive pericarditis.The main advantage of echocardiography is to provide reliable hemodynamic data for its diagnosis,which is often used as a first-line clinical screening m ethod.Computed tomography or cardiac magnetic resonance imaging can provide an important adjunctive diagnosis.This paper reviews the typical imaging features of noninvasive multimodal imaging in the diagnosis of constrictive pericarditis,the evaluation of pericardial anatomy and hemodynamics in patients with constrictive pericarditis,and its differential diagnosis with restrictive cardiomyopathy.