Магнитно-резонансная томография сердца в дифференциальной диагностике кардиомиопатий


Е.А. Мершина

Медицинский научно-образовательный центр Московского государственного университета им. М.В. Ломоносова
В обзоре освещены вопросы диагностики кардиомиопатий с помощью метода магнитно-резонансной томографии (МРТ) сердца с отсроченным внутривенным контрастированием. Уделяется внимание различным формам гипертрофической кардиомиопатии, рассматриваются вопросы дифференциальной диагностики синдрома дилатационной кардиомиопатии (ДКМП), а также приводятся обновленные диагностические критерии аритмогенной дисплазии правого желудочка и МР-критерии миокардита. Различные виды кардиомиопатий проиллюстрированы клиническими примерами.

Литература


  1. Hundley W.G., Bluemke D.A., Finn J.P. et al. SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the american college of cardiology foundation task force on expert consensus documents. Circulation. 2010; 121: 2462–2508.
  2. Gonzalez J.A., Kramer C.M. Role of imaging techniques for diagnosis, prognosis and management of heart failure patients: cardiac magnetic resonance. Curr Heart Fail Rep 2015; 12: 276–283.
  3. Edelman R.R. et al. Clinical Magnetic Resonance Imaging, 3rd ed. New York: Elsevier Press; 2005.
  4. Soriano C.J., Ridocci F., Estornell J. et al. Noninvasive diagnosis of coronary artery disease in patients with heart failure and systolic dysfunction of uncertain etiology, using late gadolinium-enhanced cardiovascular magnetic resonance JACC. 2005; 45(5): 743–48.
  5. Rudolph A., Abdel-Aty H., Bohl S. et al. Noninvasive detection of fibrosis applying contrast-enhanced cardiac magnetic resonance in different forms of left ventricular hypertrophy relation to remodeling. JACC. 2009; 53(3): 284-91.
  6. Moon J.C., Messroghli D.R., Kellman P. et al. Myocardial T1 mapping and extracellular volume quantification: SCMR and CMR Working Group of the ESC consensus statement. JCMR. 2013; 15: 92.
  7. Elliott P.M., Anastasakis A., Borger M.A., Borggref M. et al. ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy. EHJ. 2014; 35: 2733–79.
  8. Green J.J., BergerJ.S., Kramer C.M., Salerno M. Prognostic value of late gadolinium enhancement in clinical outcomes for hypertrophic cardiomyopathy. JACC Cardiovasc Imaging 2012; 5: 370–77.
  9. Prinz C., Schwarz M., Ilic I. et al. Myocardial fibrosis severity on cardiac magnetic resonance imaging predicts sustained arrhythmic events in hypertrophic cardiomyopathy. Can J Cardiol. 2013; 29: 358–63.
  10. Maron M.S., Finley J.J., Bos J.M., Hauser T.H. et al. Prevalence, clinical significance and natural history of left ventricular apical aneurysms in hypertrophic cardiomyopathy. Circulation 2008; 118: 1541–49.
  11. Brouwer W.P., Germans T., Head M.C. et al. Multiple myocardial crypts on modified long-axis view are a specific finding in pre-hypertrophic HCM mutation carriers. EHJ Cardiovasc Imaging. 2012; 13: 292–97.
  12. Maron M.S., Rowin E.J., Lin D. et al. Prevalence and clinical profile of myocardial crypts in hypertrophic cardiomyopathy. Circ Cardiovasc Imaging. 2012; 5: 441–47.
  13. Yu E.H., Omran A.S., Wigle E.D. et al. Mitral regurgitation in hypertrophic obstructive cardiomyopathy: relationship to obstruction and relief with myectomy. J Am CollCardiol. 2000; 36: 2219–25.
  14. Valeti U.S., Nishimura R.A., Holmes D.R. et al. Comparison of surgical septal myectomy and alcohol septal ablation with cardiac magnetic resonance imaging in patients with hypertrophic obstructive cardiomyopathy. JACC. 2007; 49: 350–57.
  15. McCrohon J.A., Moon J.C., Prasad S.K., McKenna W.J., Lorenz C.H., Coats A.J., Pennell D.J. Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance. Circulation. 2003, 108: 54–59.
  16. Schalla S., Bekkers S.C., Dennert R. et al. Replacement and reactive myocardial fibrosis in idiopathic dilated cardiomyopathy: comparison of magnetic resonance imaging with right ventricular biopsy. Eur J Heart Fail. 2010; 12: 227–31.
  17. Voigt A., Elgeti T., Durmus T. et al. Cardiac magnetic resonance imaging in dilated cardiomyopathy in adults—toward identification of myocardial inflammation. Eur Radiol. 2011; 21(5): 925–35.
  18. Sechtem U., Mahrholdt H., Vogelsberg H. Cardiac magnetic resonance in myocardial disease. Heart. 2007; 93: 1520–27.
  19. Mahrholdt H., Goedecke C., Wagner A. Cardiovascular magnetic resonance assessment of human myocarditis; a comparison to histology and molecular pathology. Circulation. 2004; 109: 1250–58.
  20. Friedrich M.G. et al. Cardiovascular magnetic resonance in myocarditis. A JACC White Paper. JACC. 2009; 53 (17): 1475–87.
  21. Lagan J., Schmitt M., Miller C.A. Clinical applications of multi-parametric CMR in myocarditis and systemic inflammatory diseases. Int J Cardiovasc Imaging. 2018; 34(1): 35–54.
  22. Rammos A., Meladinis V., Vovas G. et al. Restrictive Cardiomyopathies: The Importance of Noninvasive Cardiac Imaging Modalities in Diagnosis and Treatment—A Systematic Review. Radiol Res Pract. 2017.
  23. Aquaro G.D., Pingitore A., Di Bella G. et al. Prognostic Role of Cardiac Magnetic Resonance in Arrhythmogenic Right Ventricular Cardiomyopathy. AJC 2018; 122(10): 1745–53.
  24. Marcus F.I., McKenna W.J., Sherrill D. et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: Proposed Modification of the Task Force Criteria EHJ 2010; 31(7): 806–14.
  25. Petersen S., Selvanayagam J., Wiesmann F. et al. Left ventricular non-compaction: insights from cardiovascular magnetic resonance imaging. JACC 2005; 46(1): 101–05.
  26. Jacquier A., Thuny F., Jop B. et al. Measurement of trabeculated left ventricular mass using cardiac magnetic resonance imaging in the diagnosis of left ventricular non-compaction. Eur Heart J 2010; 31(9): 1098–1104.
  27. Probst S., Oechslin E., Schuler P. et al. Sarcomere gene mutations in isolated left ventricular noncompation cardiomyopathy do not predict clinical phenotype. Circ Cardiovasc Genet., 2011
  28. Hoedemaekers Y., Caliskan K., Michels M. et al. The importance of genetic counseling, DNA diagnostics, and cardiologic family screening in left ventricular noncompaction cardiomyopathy. Circ Cardiovasc Genet. 2010; 3: 232–39.


Об авторах / Для корреспонденции


Елена Александровна Мершина, зав. отделением рентгенодиагностики с кабинетами МРТ и КТ, в.н.с. отдела лучевой диагностики Медицинского научно-образовательного центра Московского государственного университета им. М.В. Ломоносова. Адрес: 119192, г. Москва, Ломоносовский пр-т, д. 27, к. 10. Тел.: 8 (495) 531-27-27. E-mail: elena_mershina@mail.ru


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