影像检查在免疫检查点抑制剂相关心肌炎中的应用进展

Advances in imaging studies of immune checkpoint inhibitors-associated myocarditis

  • 摘要: 免疫检查点抑制剂(ICIs)广泛用于肿瘤治疗,其带来的免疫相关不良事件受到越来越高的重视,其中ICIs相关心肌炎较为罕见,但致死率较高。早诊断、早干预,有利于最大程度降低ICIs的心脏毒性,进而改善患者预后。无创影像检查手段在ICIs相关心肌炎诊断中的地位至关重要。笔者旨在对ICIs致心脏毒性的流行病学,ICIs相关心肌炎的可能机制、临床表现、诊断现状、无创影像学检查方法及研究进展等进行综述,以期提高临床医师对ICIs相关心肌炎的重视程度,进一步了解ICIs相关心肌炎的影像检查手段。

     

    Abstract: Immune checkpoint inhibitors (ICIs) are widely used in cancer treatment, and their immune related adverse events (irAEs) are receiving increasing attention. Among these irAEs , ICIs-associated myocarditis is relatively rare, but the mortality rate is extremely high. Early diagnosis and intervention are beneficial for minimizing the cardiac toxicity of ICIs, and then improving patient prognosis. The role of non-invasive imaging methods in the diagnosis of ICIs-associated myocarditis is crucial. The authors aim to review the epidemiology of ICIs-associated cardiotoxicity, the possible mechanisms, clinical manifestations, the diagnosis status, non-invasive imaging methods and research progress of ICIs-associated myocarditis. Aiming at increasing the clinician’s awareness of ICIs-associated myocarditis and further undestanding the imaging methods for ICIs-associated myocarditis.

     

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