磁共振T1 mapping及ECV技术在扩张型心肌病中的应用进展

Research progress of T1 mapping MRI in dilated cardiomyopathy

扩张型心肌病(dilated cardiomyopathy,DCM)是由心室腔扩张或者扩大而导致心肌收缩功能受损,这种病症属于一种常见的、有明显家族史的心血管系统疾病。心肌磁共振钆对比剂延迟强化(late gadolinium enhancement,LGE)可被广泛用作无创心肌纤维化诊断的有效手段,但其对弥漫性心肌纤维化诊断的精确程度有所欠缺,因此在临床应用中存在一定的局限性。近年来,T1 mapping技术的临床应用为医学影像学带来了巨大的变革,特别是对于弥漫性心肌纤维化的诊断、识别、预后判断等,它可以以极高的精确度检测出T1值以及细胞外容积(extracellular volume,ECV),对DCM进行全方位评估。本文就T1 mapping及ECV在DCM患者的早期诊断、相关疾病鉴别、风险分层及预后评估和治疗疗效评估中的最新应用进展予以总结,旨在提高DCM的早期检出率,对患者的病情进展进行更加准确的判断,从而为患者制订出最佳的治疗策略,改善患者的预后,并有望为将来的研究提供参考。

Dilated cardiomyopathy(DCM)is a common disease of the cardiovascular system with a strong family history of impaired systolic function caused by the expansion or enlargement of the ventricular cavity.Late gadolinium enhancement(LGE)can be widely used as an effective means for the diagnosis of noninvasive myocardial fibrosis,but its accuracy in the diagnosis of diffuse myocardial fibrosis is lacking,so it has certain limitations in clinical application.In recent years,the clinical application of T1 mapping technology has brought great changes to medical imaging,especially for the diagnosis,recognition and prognosis of diffuse myocardial fibrosis.It can detect T1 value and extracellular volume(ECV)with high accuracy.Conduct a comprehensive evaluation of DCM.This paper summarized the latest progress in the application of T1 mapping and ECV in the early diagnosis,identification of related diseases,risk stratification,prognosis assessment and therapeutic efficacy assessment of DCM patients,aiming to improve the early detection rate of DCM and make more accurate judgment on the progression of patients'disease,so as to formulate the best treatment strategy for patients.It is expected to improve the prognosis of patients and provide a reference direction for future research.