The non-invasive biopsy: molecular imaging for the detection of cardiac involvement in systemic disease.
The non-invasive biopsy: molecular imaging for the detection of cardiac involvement in systemic disease.
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非侵入性活检：用于检测全身性疾病中心脏受累的分子成像。
DOI：
10.1093/ehjci/jeu140
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
F. Bengel
中科院分区：
文献类型：
--
作者：
F. Bengel
各种全身性疾病（如炎性疾病（结节病和移植排斥）、胆积病（淀粉样变性、法布里病和血色病）或癌症化疗）中的心脏受累越来越被认为是限制患者生存的关键因素。1为了指导预防措施和治疗，需要对心脏受累进行早期准确诊断。然而，这往往仍然是一个挑战：
肌内膜活检具有特异性，但受限于其侵入性，这妨碍了其作为早期筛查工具的使用，2以及采样误差，这可能导致未受影响区域活检的假阴性结果。非侵入性功能成像（如超声心动图、放射性核素心室造影或电影磁共振成像）可用于识别心肌病，但左心室功能障碍的检测在潜在原因方面可能是非特异性的。3因此，有一种趋势是采用更特异的技术进行非侵入性心肌组织表征：4先进的磁共振技术，如延迟钆增强，纤维化，或水肿成像可用于识别组织改变的模式，这些模式对心肌病的潜在起源更有特异性。
Cardiac involvement in various systemic conditions, such as inflammatory diseases (sarcoidosis and transplant rejection), storage diseases (amyloidosis, Fabry disease, and haemochromatosis), or cancer chemotherapy, is increasingly recognized as a key factor limiting patient survival.1 To guide preventive measures and therapy, early and accurate diagnosis of cardiac involvement is desired. This, however, often remains a challenge:
Endomyocardial biopsy is specific, but limited by its invasive nature which precludes its use as an early screening tool,2 and by sampling errors which may cause false-negative results in the case of biopsies from unaffected regions. Non-invasive functional imaging such as echocardiography, radionuclide ventriculography, or cine magnetic resonance imaging can be used to identify cardiomyopathy, but the detection of left ventricular dysfunction may be non-specific with regard to the underlying cause.3 Accordingly, there is a trend towards more specific techniques for non-invasive myocardial tissue characterization:4 advanced magnetic resonance techniques such as delayed gadolinium enhancement, fibrosis, or oedema imaging may be used to identify patterns of tissue alteration that are more specific to the underlying origin of cardiomyopathy.5 Also, radiotracer …