多模态影像评价冠状动脉微循环障碍的研究进展

Research Progress of Multimodal Imaging in the Evaluation of Coronary Microcirculation Disorders

冠状动脉微循环障碍(Coronary Microcirculation Dysfunction,CMD)指在多种致病因素的共同作用下,冠状小动脉结构或功能异常所导致的心肌缺血临床综合征。存在CMD的患者,心血管不良事件的风险发生率会显著增加。心肌灌注成像是评价心肌微循环和判断心血管疾病预后及不良事件的重要无创性检查方法。目前常用的影像检查技术包括计算机断层扫描、心脏磁共振、单光子发射计算机断层和正电子发射计算机断层成像技术、经胸多普勒超声等方法,这些方法评估心肌缺血具有较高的准确性。随着影像技术的不断发展,影像组学也在临床诊断中发挥了越来越重要的作用,对疾病的早期诊断及预后提供了可能。本文通过综述不同影像学技术在CMD诊断中的应用,探讨其在临床诊断中的不同作用,并展望影像组学在CMD评估中的潜在价值,通过对比分析,旨在为临床提供更全面的CMD诊断策略,并为未来的研究方向提供参考。

Coronary microcirculation dysfunction(CMD)is a clinical syndrome of myocardial ischemia caused by abnormal structure or function of coronary arterioles under the joint action of a variety of pathogenic factors.Patients with CMD have significantly increased risk of adverse cardiovascular events.Myocardial perfusion imaging is an important noninvasive method to evaluate myocardial microcirculation and to determine the prognosis and adverse events of cardiovascular diseases.At present,the commonly used imaging techniques include computed tomography,cardiac magnetic resonance,single photon emission computed tomography,positron emission computed tomography,transthoracic Doppler ultrasound and other methods,which have high accuracy in the evaluation of myocardial ischemia.With the continuous development of imaging technology,imaging omics has played an increasingly important role in clinical diagnosis,which provides the possibility for early prediction and prognosis of diseases.This article reviewed the application of different imaging techniques in the diagnosis of CMD,discussed their different roles in clinical diagnosis,and looked forward to the potential value of radiomics in the evaluation of CMD.Through comparative analysis,it aimed to provide a more comprehensive diagnostic strategy for CMD in clinical practice and provide reference for future research directions.