爆發(fā)性心肌炎課件

CardiacMRIoffulminantmyocarditis（FM）inchildren-canweevaluatetheshort-termoutcomes?FMisaninflammatorydiseaseofthemyocardiumthatresultsinventricularsystolicdysfunctionandcausesacuteheartfailure.Cardiacmagneticresonance(CMR)hasbecometheprimarynoninvasivetoolforthediagnosisandevaluationofmyocarditis.TheaimofourstudywastoassesstheCMRfindingsatdifferentcourseofFMandtheshort-termoutcomesofFMinchildren.EightFMchildrenwithCMRexaminationswereincludedinourstudy.Themedianageofeightchildrenwas8.5yearsold.InitialbaselineCMRwasperformed10days(range,7-20days)afteronsetofFMandfollow-upCMRafter55days(range,33-75days).

TheinitialCMRfindingsweremostcommonwithearlygadoliniumenhancement(EGE,100%)andlategadoliniumenhancement(LGE,87.5%),increasedseptalthickness(75.0%)andincreasedleftventricleejectionfraction(LVEF,50.0%).Statisticallysignificantdifferenceswerefoundbetweeninitialandfollow-upCMRabnormalitiesintheseptalthickness,leftventricularend-diastolicdiameter(LVEDD),end-systolicvolume(ESV),LVEF,andLGEarea.TheclinicalmanifestationsofFMwerevaried,includingheartfailure(eightcases,100.0%),cardiacshock(fourcases,50.0%)andAdams-Stokessyndrome(fourcases,50.0%).ST-Tchangesintheelectrocardiographic(ECG)examinationswereobservedinallFMchildren(100%),followedbyIII°atrioventricularblock(AVB,62.5%).Comparedwithfollow-upCMR,FMchildrenatbaselineCMRshowedincreasedseptalthickness,increasedLVmass,higherEF,smallerLVEDDandlowerESV.ThepresenceofIII°AVBandsmallerLGEareaatbaselineCMRmightindicatebettershort-termoutcomes.Theshort-termoutcomesofFMinchildrenwereevaluatedaccordingtoclinicalmanifestations,immunologicalfeaturesandCMRfindingsatfollow-upCMR.Fullrecoveryofclinicalmanifestations,immunologicalfeaturesandCMRfindingscouldbefoundinfiveFMchildren(62.5%)atfollow-upCMR.Abnormal