心脏移植后免疫介导并发症的多式心脏成像:当代审查
Bruno Bezerra Lima1,2, Tam T Doan3, Atilla Feher4
1Department of Medicine, Cardiology Division Vanderbilt University Medical Center Nashville TN USA.
Journal of the American Heart Association
|November 26, 2025
概括
非侵入性成像技术,如回声心脏图像和MRI可以帮助监测心脏移植接受者拒绝和心脏合移植血管病变 (CAV),减少侵入性活检的需要.
科学领域:
- 心脏病学和移植医学
- 医学成像和诊断 医学成像和诊断
背景情况:
- 心脏移植改善了末期心力衰竭的存活率,但面临着急性排斥和心脏合移植血管病变 (CAV) 等免疫并发症的挑战.
- 目前的诊断标准,内心肌组织活检以检测排斥和冠状动脉血管学以检测CAV,是侵入性的,并且有局限性.
- 非侵入性多模式成像为补充或取代侵入性检测提供了一个有希望的替代方案.
研究的目的:
- 审查心脏移植监测中各种非侵入性成像方法的优点,局限性和实际应用.
- 为了突出定量成像技术的附加值.
- 为成人和儿科心脏移植接受者提供基于证据的监测框架.
主要方法:
- 关于心声回声,核成像 (PET),心脏磁共振 (CMR) 和心脏计算机断层扫描血管学 (CCTA) 的当代文献的综述.
- 专注于定量成像技术,以提高诊断准确度.
- 在移植后护理和患者群体的不同阶段对成像作用的综合分析.
主要成果:
- 带有应力和应力回声心电图的回声心电图可以检测早期功能障碍并评估CAV.
- 与定性方法相比,定量PET和CMR输液成像提高了CAV检测.
- CMR组织映射有助于识别与排斥相关的胀和纤维化;CCTA提供解剖学和生理学评估.
结论:
- 整合非侵入性多模式成像可以减少对侵入性手术的依赖,降低风险,并在心脏移植监测中改进治疗决策.
- 定量成像方法提供增量诊断价值.
- 使用这些模式的量身定制,阶段性监测框架对于长期的移植成功至关重要,特别是在儿科患者中.
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