Significance of late gadolinium enhancement in cardiovascular magnetic resonance imaging (CMR)
Significance of late gadolinium enhancement in cardiovascular magnetic resonance imaging (CMR)
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DOI：
10.1007/s00059-007-2972-5
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发表时间：
2007-03-01
期刊：
影响因子：
1.7
通讯作者：
Sechtem, Udo
中科院分区：
文献类型：
--
作者：
Voehringer, Matthias;Mahrholdt, Heiko;Sechtem, Udo
心血管磁共振成像(CMR)通过使用基于Gd的造影剂和特殊的磁共振脉冲序列，可以在正常和病变心肌之间进行最佳区分。在应用造影剂后10-20分钟进行成像，以产生所谓的晚期Gd增强(LGE)图像，该图像描绘了具有良好重复性的病变心肌。与组织病理学比较，显示LGE的区域对应于心肌细胞坏死区或心肌纤维化区。本文描述了缺血性心脏病、扩张型心肌病、肥厚型心肌病和其他炎症性或浸润性心肌病的典型高强化表现。LGE-CMR有助于鉴别晚期缺血性心脏病和非缺血性扩张型心肌病。在缺血性心脏病中，LGE还可以通过直接显示剩余存活心肌来预测血管重建术后的功能恢复。LGE也可用于预测缺血性心脏病或非缺血性心肌病患者的恶性心律失常。这可能会导致未来LGE-CMR作为预后工具的作用增加。
Cardiovascular magnetic resonance imaging (CMR) permits optimal differentiation between normal and diseased myocardium with the use of gadolinium-based contrast agents and special magnetic resonance pulse sequences. Imaging is performed 10-20 min after contrast agent application to produce so-called late gadolinium enhancement (LGE) images which depict diseased myocardium with excellent reproducibility. Areas showing LGE correspond to zones of myocyte necrosis or myocardial fibrosis as shown by comparison with histopathology. Typical patterns of hyperenhancement exist in ischemic heart disease but also in dilated cardiomyopathy, hypertrophic cardiomyopathy and other inflammatory or infiltrative myocardial disease and are described in this article. LGE-CMR is helpful to distinguish advanced ischemic heart disease from nonischemic dilated cardiomyopathy. In ischemic heart disease LGE can also predict the functional recovery after revascularization procedures by directly showing the remaining viable myocardium. LGE may also become useful to predict malignant arrhythmias in patients with ischemic heart disease or nonischemic cardiomyopathy. This may lead in future to an increased role of LGE-CMR as a prognostic tool.