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Abstract：
Takotsubo syndrome (TTS) is a complex and still poorly recognized heart disease with a wide spectrum of possible clinical presentations. Despite its reversibility, it is associated with serious adverse in-hospital events and high complication rates during follow-up. Multimodality imaging is helpful for establishing the diagnosis, guiding therapy, and stratifying prognosis of TTS patients in both the acute and post-acute phase. Echocardiography plays a key role, particularly in the acute care setting, allowing for the assessment of left ventricular (LV) systolic and diastolic function and the identification of the typical apical-midventricular ballooning pattern, as well as the circumferential pattern of wall motion abnormalities. It is also useful in the early detection of complications (i.e. LV outflow tract obstruction, mitral regurgitation, right ventricular involvement, LV thrombi, and pericardial effusion) and monitoring of systolic function recovery. Left ventriculography allows the evaluation of LV function and morphology, identifying the typical TTS patterns when echocardiography is not available or wall motion abnormalities cannot be properly assessed with ultrasound. Cardiac magnetic resonance provides a more comprehensive depiction of cardiac morphology and function and tissue characterization and offers additional value to other imaging modalities for differential diagnosis (myocardial infarction and myocarditis). Coronary computed tomography angiography has a substantial role in the diagnostic workup of patients with acute chest pain and a doubtful TTS diagnosis to rule out other medical conditions. It can be considered as a non-invasive appropriate alternative to coronary angiography in several clinical scenarios. Although the role of nuclear imaging in TTS has not yet been well established, the combination of perfusion and metabolic imaging may provide useful information on myocardial function in both the acute and post-acute phase.
摘要：
Takotsubo综合征（TTS）是一种复杂且仍未得到认可的心脏病，具有广泛的可能临床表现。尽管它具有可逆性，它与严重不良住院事件和随访期间高并发症发生率相关.多模态成像有助于建立诊断，指导治疗,并对TTS患者急性期和急性期后的预后进行分层。超声心动图起着关键作用，特别是在急性护理环境中，允许评估左心室（LV）收缩和舒张功能，并鉴定典型的心尖-中室膨胀模式，以及壁运动异常的圆周模式。它还可用于早期发现并发症（即LV流出道阻塞，二尖瓣反流,右心室受累,左心室血栓,和心包积液）并监测收缩功能恢复。左心室造影可以评估左心室功能和形态，当无法进行超声心动图检查或无法通过超声正确评估壁运动异常时，识别典型的TTS模式。心脏磁共振提供了对心脏形态和功能以及组织表征的更全面的描述，并为其他成像方式的鉴别诊断（心肌梗塞和心肌炎）提供了额外的价值。冠状动脉计算机断层扫描血管造影在急性胸痛患者的诊断检查和可疑的TTS诊断中具有重要作用，以排除其他医疗状况。在几种临床情况下，它可以被认为是冠状动脉造影的非侵入性替代方法。尽管核成像在TTS中的作用尚未得到很好的确立,灌注和代谢成像的结合可为急性和急性后心肌功能提供有用的信息.
