Cardiac MRI-based multi-modality imaging in clinical decision-making: Preliminary assessment of a management algorithm for patients with suspected cardiac mass
Cardiac MRI-based multi-modality imaging in clinical decision-making: Preliminary assessment of a management algorithm for patients with suspected cardiac mass
复制标题
基于心脏 MRI 的多模态成像在临床决策中的应用：对疑似心脏质量患者的管理算法进行初步评估。
DOI：
10.1016/j.ijcard.2015.09.021
复制
发表时间：
2016-01-15
影响因子：
3.5
通讯作者：
Chen, Yucheng
中科院分区：
文献类型：
--
作者：
Zhu, Da;Yin, Senlin;Chen, Yucheng
背景：心脏肿块是一种罕见的疾病，发病率和死亡率高，对治疗提出了挑战。本研究的目的是评价基于心脏MRI的多模式成像在心脏肿块患者临床决策中的潜在作用。方法：2011年11月至2014年5月，59例可疑心脏肿块的患者(女性33例，平均年龄48.2±21.1岁，0.6~85岁)进入这项前瞻性单中心研究，接受基于MRI的多模式成像，并对其生存状况进行随访。治疗策略(手术、化疗或观察)根据患者的临床情况和心脏肿块的影像特征(位置、形态、血流动力学、栓塞风险、转移和可切除性)。结果：心脏MRI诊断为心脏内肿瘤39例(良性28例，恶性11例)，假性肿瘤20例(血栓13例，囊肿4例，脂肪浸润性3例)，34例(23个肿瘤，11个假瘤)符合手术切除条件，4例行PET-CT扫描，进一步了解肿瘤的特征和转移情况。病理检查显示心脏MRI对良、恶性肿瘤的鉴别准确率高(96%)，对肿瘤与假瘤的鉴别准确率高(100%)。未经手术治疗的16例心脏肿瘤患者中，9例MRI多模式成像为“良性”肿块的患者在随访中存活，7例“恶性”患者全部死亡；9例未经手术治疗的假瘤患者生存状况良好。中位随访期2年(10天~3年)。结论：基于心脏MRI的多模式成像有助于可疑心脏肿块患者的危险分层和临床决策。(C)2015爱思唯尔爱尔兰有限公司。保留所有权利。
Background: Cardiac masses are rare with high morbidity and mortality that challenging the management. The purpose of this study was to evaluate the potential role of cardiac-MRI based multi-modality imaging in the clinical decision-making for patients with cardiac mass.Methods: From November 2011 to May 2014, 59 consecutive patients (33 females; mean age, 48.2 +/- 21.1 [range, 0.6-85] years) with suspected cardiac mass were enrolled in this prospective single center study, underwent MRI based multi-modality imaging and were followed up for survival status. Management strategy (surgery, chemotherapy or observation) was based on patient's clinical status and cardiac mass imaging characteristics (location, morphology, hemodynamics, embolization risk, metastasis, and resectability).Results: Using cardiac MRI, 39 patients were diagnosed with intra-cardiac neoplasm (28 benign, 11 malignant) and 20 with pseudo-tumors (13 thrombi, 4 cysts and 3 fat infiltration); 34 masses (23 neoplasms, 11 pseudo-tumors) were eligible for surgical removal, and 4 underwent PET-CT scan to further delineate characteristics and metastasis. Pathological examination revealed high accuracy of cardiac MRI in differentiating benign from malignant tumors (96%), and neoplasm from pseudo-tumors (100%). As for the 16 patients with cardiac neoplasm not surgically treated, the 9 with "benign" masses as per MRI-based multimodality imaging survived during follow-up, while all 7 with "malignancy" died; the 9 with pseudo-tumors not surgically treated also survived with good condition. The median follow-up period is 2 years (10 days-3 years).Conclusion: Cardiac MRI based multimodality imaging appears useful for risk stratification and clinical decision making for patients with suspected cardiac mass. (C) 2015 Elsevier Ireland Ltd. All rights reserved.