The importance of heart and brain imaging in children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C).
The importance of heart and brain imaging in children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C).
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DOI：
10.1007/s00296-021-04845-z
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发表时间：
2021-06
影响因子：
4
通讯作者：
Fotis L
中科院分区：
文献类型：
--
作者：
Mavrogeni SI;Kolovou G;Tsirimpis V;Kafetzis D;Tsolas G;Fotis L
最近报道，少数受 SARS-CoV-2 影响的儿童出现了儿童多系统炎症综合征 (MIS-C)，类似于川崎病 (KD)，这是一种原因不明的中型血管炎。与儿童中通常较轻的急性 COVID-19 感染相比，68% 的 MIS-C 患者将需要重症监护室。 MIS-C 的主要心血管并发症包括心肌炎和冠状动脉扩张/动脉瘤。因此，在诊断和随访期间都需要进行密切的临床评估。超声心动图是急性期心肌功能和冠状动脉评估的基石方式。心血管磁共振 (CMR) 可检测恢复期和青少年期间的弥漫性心肌炎症，包括水肿/纤维化、心肌灌注和冠状动脉解剖结构，而超声心动图可能无法提供足够的图像。与心血管疾病相比，MIS-C 的大脑受累较少见。然而，这并不罕见，应该通过临床评估和脑磁共振（MRI）进行监测，因为我们仍然不知道它对大脑发育的影响。 MIS-C 中的脑 MRI 显示与弥散受限和双侧丘脑病变相关的 T2 高信号病变。总而言之，MIS-C 是一种多系统疾病，影响许多重要器官，例如心脏和大脑。临床意识、创新高科技成像模式的应用以及包括支持性药物和抗炎药物在内的先进治疗方案将有助于医生预防 MIS-C 的可怕并发症。
Multisystem Inflammatory Syndrome in Children (MIS-C) recently reported in a minority of children affected by SARS-CoV-2, mimics Kawasaki disease (KD), a medium vessel vasculitis of unknown cause. In contrast to acute COVID-19 infection, which is usually mild in children, 68% of patients with MIS-C will need intensive care unit. Myocarditis and coronary artery ectasia/aneurysm are included between the main cardiovascular complications in MIS-C. Therefore, close clinical assessment is need it both at diagnosis and during follow-up. Echocardiography is the cornerstone modality for myocardial function and coronary artery evaluation in the acute phase. Cardiovascular magnetic resonance (CMR) detects diffuse myocardial inflammation including oedema/fibrosis, myocardial perfusion and coronary arteries anatomy during the convalescence and in adolescents, where echocardiography may provide inadequate images. Brain involvement in MIS-C is less frequent compared to cardiovascular disease. However, it is not unusual and should be monitored by clinical evaluation and brain magnetic resonance (MRI), as we still do not know its effect in brain development. Brain MRI in MIS-C shows T2-hyperintense lesions associated with restricted diffusion and bilateral thalamic lesions. To conclude, MIS-C is a multisystem disease affecting many vital organs, such as heart and brain. Clinical awareness, application of innovative, high technology imaging modalities and advanced treatment protocols including supportive and anti-inflammatory medication will help physicians to prevent the dreadful complications of MIS-C.
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DOI：
10.1007/s10554-020-02089-9
发表时间：
2021-04
期刊：
The international journal of cardiovascular imaging
影响因子：
--
作者：
Cau R;Bassareo PP;Mannelli L;Suri JS;Saba L
通讯作者：
Saba L
DOI：
10.1002/art.41616
发表时间：
2021-04
期刊：
Arthritis & rheumatology (Hoboken, N.J.)
影响因子：
--
作者：
Henderson LA;Canna SW;Friedman KG;Gorelik M;Lapidus SK;Bassiri H;Behrens EM;Ferris A;Kernan KF;Schulert GS;Seo P;Son MBF;Tremoulet AH;Yeung RSM;Mudano AS;Turner AS;Karp DR;Mehta JJ
通讯作者：
Mehta JJ
影响因子：
8
作者：
Dionne, Audrey;Mah, Douglas Y.;Friedman, Kevin G.
通讯作者：
Friedman, Kevin G.
严重的COVID-19，儿童的多系统炎症综合征和川崎疾病：免疫机制，临床表现和管理。
影响因子：
4
作者：
Kabeerdoss J;Pilania RK;Karkhele R;Kumar TS;Danda D;Singh S
通讯作者：
Singh S
影响因子：
1.7
作者：
Bektaş G;Akçay N;Boydağ K;Şevketoğlu E
通讯作者：
Şevketoğlu E