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Kardiale Magnetresonanztomographie in der Diagnostik der restriktiven und unklassifizierten Kardiomyopathien

Cardiac magnetic resonance tomography in the diagnostics of restrictive and unclassified cardiopathies

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Zusammenfassung

Klinisches/methodisches Problem

Kardiomyopathien stellen neben den ischämischen Herzerkrankungen eine wesentliche Ursache für die Entwicklung einer Herzinsuffizienz und den plötzlichen Herztod dar.

Radiologische Standardverfahren

Das diagnostische Spektrum bei Kardiomyopathien umfasst nichtinvasive und invasive Untersuchungsmethoden.

Methodische Innovationen

Die exakte Diagnosesicherung einzelner Krankheitsbilder erfordert zum einen die Kenntnis der aktuellen Klassifikationen der heterogenen Gruppe der Kardiomyopathien, zum anderen sind oft spezielle Untersuchungstechniken erforderlich.

Leistungsfähigkeit

Moderne bildgebende Verfahren stellen einen zentralen Bestandteil der diagnostischen Möglichkeiten bei der Abklärung einer Kardiomyopathie dar. Neben der Echokardiographie ist hier insbesondere die kardiale Magnetresonanztomographie (MRT) zu nennen.

Bewertung

Mit zunehmendem Verständnis über die Pathogenese einzelner Kardiomyopathien konnten diagnostische Kriterien für die kardiale MRT definiert werden, weshalb heute ein regelmäßiger Einsatz der MRT zur Differenzierung einer restriktiven oder unklassifizierten Kardiomyopathie gerechtfertigt ist.

Empfehlung für die Praxis

Die Echokardiographie ist das bildgebende Verfahren der Wahl bei der Abklärung einer unklaren Herzinsuffizienz. Die kardiale MRT sollte jedoch bei Unklarheiten frühzeitig in den diagnostischen Algorithmus eingebunden werden.

Abstract

Clinical/methodical issue

Besides ischemic heart disease cardiomyopathies are common causes of heart failure and sudden cardiac death.

Standard radiological methods

The diagnostic spectrum in cardiomyopathies comprises non-invasive and invasive examination techniques.

Methodical innovations

The exact verification of certain cardiomyopathies necessitates knowledge of the latest classification of cardiomyopathies as well as dedicated examination protocols.

Performance

Modern imaging modalities, such as echocardiography and cardiac magnetic resonance imaging (MRI) have emerged as useful imaging tools in the investigation of patients suspected of having many different types of cardiomyopathies.

Achievements

Based on a better understanding of the underlying pathophysiology several diagnostic criteria have been defined using cardiac MRI. In particular there is an increasing importance of cardiac MRI in the description of patients with restrictive and unclassified cardiomyopathies.

Practical recommendations

Echocardiography still remains the modality of choice in the diagnostics of unclear left ventricular heart failure. Further diagnostic work-up should include cardiac MRI in case of any lack of clarity.

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Authors and Affiliations

  1. Abteilung für Diagnostische und Interventionelle Radiologie, Radiologische Klinik, Universität Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland

    U. Kramer, S. Mangold, P. Krumm & C.D. Claussen

  2. Medizinische Klinik III, Abteilung für Kardiologie und Kreislauferkrankungen, Universität Tübingen, Tübingen, Deutschland

    A.E. May

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  1. U. Kramer
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Correspondence to U. Kramer.

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Kramer, U., May, A., Mangold, S. et al. Kardiale Magnetresonanztomographie in der Diagnostik der restriktiven und unklassifizierten Kardiomyopathien. Radiologe 53, 45–53 (2013). https://doi.org/10.1007/s00117-012-2384-2

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  • DOI: https://doi.org/10.1007/s00117-012-2384-2

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