Abstract:
Cardiac magnetic resonance (CMR) imaging is a valuable noninvasive tool for evaluating tissue response following catheter ablation of atrial tissue. This review provides an overview of the contemporary CMR strategies to visualize atrial ablation lesions in both the acute and chronic postablation stages, focusing on their strengths and limitations. Moreover, the accuracy of CMR imaging in comparison to atrial lesion histology is discussed. T2-weighted CMR imaging is sensitive to edema and tends to overestimate lesion size in the acute stage after ablation. Noncontrast agent-enhanced T1-weighted CMR imaging has the potential to provide more accurate assessment of lesions in the acute stage but may not be as effective in the chronic stage. Late gadolinium enhancement imaging can be used to detect chronic atrial scarring, which may inform repeat ablation strategies. Moreover, novel imaging strategies are being developed, but their efficacy in characterizing atrial lesions is yet to be determined. Overall, CMR imaging has the potential to provide virtual histology that aids in evaluating the efficacy and safety of catheter ablation and monitoring of postprocedural myocardial changes. However, technical factors, scanning during arrhythmia, and transmurality assessment pose challenges. Therefore, further research is needed to develop CMR strategies to visualize the ablation lesion maturation process more effectively.
摘要:
心脏磁共振(CMR)成像是评估导管消融心房组织后组织反应的有价值的非侵入性工具。这篇综述概述了当代CMR策略,以可视化急性和慢性消融后阶段的心房消融损伤。专注于他们的优势和局限性。此外,讨论了与心房病变组织学相比,CMR成像的准确性。T2加权CMR成像对水肿敏感,并且在消融后的急性期倾向于高估病变大小。非造影剂增强的T1加权CMR成像有可能在急性期提供更准确的病变评估,但在慢性期可能效果不佳。晚期钆增强成像可用于检测慢性心房瘢痕,这可以告知重复消融策略。此外,正在开发新的成像策略,但它们在表征心房病变方面的功效尚待确定。总的来说,CMR成像有可能提供虚拟组织学,有助于评估导管消融的疗效和安全性以及监测术后心肌变化。然而,技术因素,在心律失常期间扫描,和跨壁性评估提出了挑战。因此,需要进一步的研究来制定CMR策略,以更有效地可视化消融损伤成熟过程.