心脏核磁共振在缺血性心肌病中的应用

Application of Cardiac Magnetic Resonance Imaging in Ischemic Cardiomyopathy

摘要: 缺血性心肌病是导致死亡和发病的重要原因，特别需要准确的诊断和预后特征。心脏磁共振(CMR)可以通过对心肌功能、灌注和组织成分进行全面评估来帮助满足这些要求，在指导已知或疑似缺血性心肌病患者的临床管理方面具有实用性。CMR能够提供有关心脏病理生理的准确性(功能与灌注)或特殊(组织特征)信息，同时避免暴露于电离辐射并克服与成像窗口质量相关的限制。特别是，应力灌注被证明是准确、安全、具体成本效益的，并且作为检测心肌缺血严重程度和分布的非侵入性测试具有临床价值。然而心脏MRI提供了重要的临床信息，其广泛应用仍面临高成本、设备可获取性及操作技术要求高等挑战。未来研究需继续优化成像技术，扩大技术的可接受度和可访问性，同时降低成本，提高设备普及率，以便更多患者能够受益。

Abstract: Ischemic cardiomyopathy is an important cause of death and morbidity, requiring accurate diagnosis and prognostic features. Cardiac magnetic resonance imaging (CMR) can help meet these requirements by comprehensively evaluating cardiac function, perfusion, and tissue composition, and is practical in guiding clinical management of patients with known or suspected ischemic myocardium. CMR can provide accurate (functional and perfusion) or specific (tissue characteristics) information about cardiac pathophysiology, while avoiding exposure to ionizing radiation and overcoming limitations related to imaging window quality. Especially, stress perfusion has been proven to be accurate, safe, and cost-effective, and has clinical value as a non-invasive test for detecting the severity and distribution of myocardial ischemia. However, cardiac MRI provides important clinical information, but its widespread application still faces challenges such as high cost, equipment accessibility, and high operational technical requirements. Future research needs to continue optimizing imaging technology, expanding its acceptability and accessibility, while reducing costs and increasing device adoption, so that more patients can benefit.