乳腺癌已发展为全球第一大癌,随着诊治手段的进步,乳腺癌患者生存时间不断延长,但抗肿瘤治疗会引发心脏相关并发症,出现癌症治疗相关心功能障碍(cancer therapy related cardiac dysfunction,CTRCD)。CTRCD始于亚临床心肌细胞损伤,最终...乳腺癌已发展为全球第一大癌,随着诊治手段的进步,乳腺癌患者生存时间不断延长,但抗肿瘤治疗会引发心脏相关并发症,出现癌症治疗相关心功能障碍(cancer therapy related cardiac dysfunction,CTRCD)。CTRCD始于亚临床心肌细胞损伤,最终发展为有症状的心力衰竭。因此,准确评估CTRCD的发生和严重程度对于肿瘤患者的治疗和康复至关重要。随着医疗技术的不断进步,心脏影像学成为评估和管理心脏健康的关键工具,包括超声心动图、心脏计算机断层扫描(cardiac computed tomography,CCT)、心脏磁共振成像(cardiac magnetic resonance imaging,CMRI)等,在提供心脏结构和功能信息的基础上,组织特定性成像、应变成像、灌注成像等在早期识别和评估CTRCD中发挥关键作用。本文就不同影像检查技术在乳腺癌患者化疗后心功能障碍研究中的进展进行文献综述,重点论述磁共振技术在此方面的进展,以期为早期检测CTRCD提供更为精确的影像生物信息。展开更多
肥厚型心肌病(hypertrophic cardiomyopathy,HCM是一种以左心室肥厚而不伴心室腔扩大为解剖特点的儿童常见心肌病,是青少年运动猝死的最主要原因之一,而尽早地发现症状、及时地诊断治疗对于防范青少年运动猝死和改善预后具有重要价值。...肥厚型心肌病(hypertrophic cardiomyopathy,HCM是一种以左心室肥厚而不伴心室腔扩大为解剖特点的儿童常见心肌病,是青少年运动猝死的最主要原因之一,而尽早地发现症状、及时地诊断治疗对于防范青少年运动猝死和改善预后具有重要价值。目前对于HCM的诊断主要根据病史、体征和超声心动图以及家族史和基因检查得以明确。近年来心脏磁共振(cardiac magnetic resonance,CMR)以及CT检查对于HCM的诊断越来越重要。该文主要从心脏磁共振以及CT检查对HCM的诊断价值进行探讨。展开更多
Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease.For this reason,screening of asymptomatic coronary atherosclerosis has become an attractive field of res...Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease.For this reason,screening of asymptomatic coronary atherosclerosis has become an attractive field of research in cardiovascular medicine.Necropsy studies have described histopathological changes associated with the development of acute coronary events.In this regard,thin-cap fibroatheroma has been identified as the main vulnerable coronary plaque feature.Hence,many imaging techniques,such as coronary computed tomography,cardiac magnetic resonance or positron emission tomography,have tried to detect noninvasively these histomorphological characteristics with different approaches.In this article,we review the role of these diagnostic tools in the detection of vulnerable coronary plaque with particular interest in their advantages and limitations as well as the clinical implications of the derived findings.展开更多
Coronary artery disease is the leading cause of death in advanced countries and its prevalence is increasing among the developing countries.Cardiac computed tomography(CT) has been increasingly used in the diagnosis o...Coronary artery disease is the leading cause of death in advanced countries and its prevalence is increasing among the developing countries.Cardiac computed tomography(CT) has been increasingly used in the diagnosis of coronary artery disease due to its rapid improvements in multislice CT scanners over the last decade,and this less-invasive technique has become a potentially effective alternative to invasive coronary angiography.Quantifying the amount of coronary artery calcium with cardiac CT has been widely accepted as a reliable non-invasive technique for predicting risk of future cardiovascular events.However,the main question that remains uncertain is whether routine,widespread coronary artery calcium scoring in an individual patient will result in an overall improvement in quality of care and clinical outcomes.In this commentary,we discuss a current issue of the clinical value of coronary artery calcium scoring with regard to its value of predicting adverse cardiac events.We also discuss the applications of coronary artery calcium scores in patients with different risk groups.展开更多
BACKGROUND The association of two congenital coronary artery anomalies(CAAs) is extremely rare but represents one of the main cause of sudden cardiac death in young athletes. Although coronary angiography(CX-A) is sti...BACKGROUND The association of two congenital coronary artery anomalies(CAAs) is extremely rare but represents one of the main cause of sudden cardiac death in young athletes. Although coronary angiography(CX-A) is still widely used in childhood, cardiac magnetic resonance(C-MRI) and cardiac computed tomography(C-CT) have recently taken on an increasing diagnostic role in early detection of CAAs and concomitant congenital cardiac malformations.CASE SUMMARY A healthy 10-year-old male patient was referred to the Radiological Department of our Institution due to no evidence of left coronary artery in echocardiographic examination. With C-MRI was detected marked myocardial trabeculation and was suspected anomalous origin and course of left circumflex(LCx) artery and of left anterior descending(LAD) artery. With third generation Dual Source C-CT192x2-sections(SOMATOM Force, Siemens, Germany) was confirmed anomalous origin of LCx artery from right pulmonary artery associated with anomalous origin of LAD artery from right coronary artery with course in front of right ventricular outflow tract. The patient underwent surgical treatment with reimplantation of the anomalous LCX and LAD arteries into the wall of ascending aorta, with no postoperative complications. The patient remained asymptomatic and follow-up C-MRI scan four months after operation showed complete success of surgery treatment.CONCLUSION This case highlights the diagnostic potential of C-CT and C-MRI in evaluation of CAAs and of cardiac morphology and functionality, with very low radiation dose and without the risks related to invasive procedure.展开更多
文摘乳腺癌已发展为全球第一大癌,随着诊治手段的进步,乳腺癌患者生存时间不断延长,但抗肿瘤治疗会引发心脏相关并发症,出现癌症治疗相关心功能障碍(cancer therapy related cardiac dysfunction,CTRCD)。CTRCD始于亚临床心肌细胞损伤,最终发展为有症状的心力衰竭。因此,准确评估CTRCD的发生和严重程度对于肿瘤患者的治疗和康复至关重要。随着医疗技术的不断进步,心脏影像学成为评估和管理心脏健康的关键工具,包括超声心动图、心脏计算机断层扫描(cardiac computed tomography,CCT)、心脏磁共振成像(cardiac magnetic resonance imaging,CMRI)等,在提供心脏结构和功能信息的基础上,组织特定性成像、应变成像、灌注成像等在早期识别和评估CTRCD中发挥关键作用。本文就不同影像检查技术在乳腺癌患者化疗后心功能障碍研究中的进展进行文献综述,重点论述磁共振技术在此方面的进展,以期为早期检测CTRCD提供更为精确的影像生物信息。
文摘肥厚型心肌病(hypertrophic cardiomyopathy,HCM是一种以左心室肥厚而不伴心室腔扩大为解剖特点的儿童常见心肌病,是青少年运动猝死的最主要原因之一,而尽早地发现症状、及时地诊断治疗对于防范青少年运动猝死和改善预后具有重要价值。目前对于HCM的诊断主要根据病史、体征和超声心动图以及家族史和基因检查得以明确。近年来心脏磁共振(cardiac magnetic resonance,CMR)以及CT检查对于HCM的诊断越来越重要。该文主要从心脏磁共振以及CT检查对HCM的诊断价值进行探讨。
文摘Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease.For this reason,screening of asymptomatic coronary atherosclerosis has become an attractive field of research in cardiovascular medicine.Necropsy studies have described histopathological changes associated with the development of acute coronary events.In this regard,thin-cap fibroatheroma has been identified as the main vulnerable coronary plaque feature.Hence,many imaging techniques,such as coronary computed tomography,cardiac magnetic resonance or positron emission tomography,have tried to detect noninvasively these histomorphological characteristics with different approaches.In this article,we review the role of these diagnostic tools in the detection of vulnerable coronary plaque with particular interest in their advantages and limitations as well as the clinical implications of the derived findings.
文摘Coronary artery disease is the leading cause of death in advanced countries and its prevalence is increasing among the developing countries.Cardiac computed tomography(CT) has been increasingly used in the diagnosis of coronary artery disease due to its rapid improvements in multislice CT scanners over the last decade,and this less-invasive technique has become a potentially effective alternative to invasive coronary angiography.Quantifying the amount of coronary artery calcium with cardiac CT has been widely accepted as a reliable non-invasive technique for predicting risk of future cardiovascular events.However,the main question that remains uncertain is whether routine,widespread coronary artery calcium scoring in an individual patient will result in an overall improvement in quality of care and clinical outcomes.In this commentary,we discuss a current issue of the clinical value of coronary artery calcium scoring with regard to its value of predicting adverse cardiac events.We also discuss the applications of coronary artery calcium scores in patients with different risk groups.
文摘BACKGROUND The association of two congenital coronary artery anomalies(CAAs) is extremely rare but represents one of the main cause of sudden cardiac death in young athletes. Although coronary angiography(CX-A) is still widely used in childhood, cardiac magnetic resonance(C-MRI) and cardiac computed tomography(C-CT) have recently taken on an increasing diagnostic role in early detection of CAAs and concomitant congenital cardiac malformations.CASE SUMMARY A healthy 10-year-old male patient was referred to the Radiological Department of our Institution due to no evidence of left coronary artery in echocardiographic examination. With C-MRI was detected marked myocardial trabeculation and was suspected anomalous origin and course of left circumflex(LCx) artery and of left anterior descending(LAD) artery. With third generation Dual Source C-CT192x2-sections(SOMATOM Force, Siemens, Germany) was confirmed anomalous origin of LCx artery from right pulmonary artery associated with anomalous origin of LAD artery from right coronary artery with course in front of right ventricular outflow tract. The patient underwent surgical treatment with reimplantation of the anomalous LCX and LAD arteries into the wall of ascending aorta, with no postoperative complications. The patient remained asymptomatic and follow-up C-MRI scan four months after operation showed complete success of surgery treatment.CONCLUSION This case highlights the diagnostic potential of C-CT and C-MRI in evaluation of CAAs and of cardiac morphology and functionality, with very low radiation dose and without the risks related to invasive procedure.
