Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector11486610.17816/KMJ114866ReviewsОбзорыReview ArticlePossibilities of computed and magnetic resonance imaging of the heart in patients with ­atrial fibrillationВозможности компьютерной и магнитно-резонансной томографии сердца у пациентов с фибрилляцией предсердийhttps://orcid.org/0000-0001-7403-0200GalyautdinovGenshat S.ГаляутдиновГеншат Саляхутдинович
Russian Federation

M.D., D. Sci. (Med.), Prof., Depart. of Hospital Therapy, Deputy Dean of the Faculty of Medicine

докт. мед. наук, проф., каф. госпитальной терапии, зам. декана лечебного факультета

galgen077@mail.ruhttps://orcid.org/0000-0001-5300-0635IbragimovaKarina R.ИбрагимоваКарина Рафатовна
Russian Federation

Clinical pharmacologist

врач-клинический фармаколог

skmalina@mail.ruhttps://orcid.org/0000-0001-8654-1112GaleevaShamilya Sh.ГалееваШамиля Шамилевна
Russian Federation

Resident, Depart. of Hospital Therapy

ординатор, каф. госпитальной терапии

g.s.0101@yandex.ruKazan State Medical UniversityКазанский государственный медицинский университетInterdistrict multidisciplinary hospital of AlmetyevskАльметьевская межрайонная многопрофильная больница01022023104189983011202226122022Copyright ©; 2023, Eco-VectorCopyright ©; 2023, Эко-Вектор2023Eco-VectorЭко-Векторhttps://kazanmedjournal.ru/kazanmedj/article/view/114866

Computed and magnetic resonance imaging of the heart has been widely used in recent years in patients with atrial fibrillation. They are used to determine the morphology of the heart, the presence of intracardiac thrombi, quantify the structures of the heart, thrombosis of intracardiac devices, determine tactics for surgical interventions, and other purposes. These methods of instrumental diagnostics can be used as an alternative to transesophageal echocardiography, which has a number of limitations and disadvantages compared to computed tomography and magnetic resonance imaging. Computed and magnetic resonance imaging of the heart are used to avoid invasiveness in the study of the heart, to improve the accuracy of measuring heart structures, to reduce the number of diagnostic methods used before various surgical interventions in patients with atrial fibrillation, and also, according to epidemic indications, as part of the prevention of the spread of coronavirus infection. In addition, magnetic resonance imaging allows to avoid radiation exposure to the patient. The review presents the results of studies, meta-analyses of pooled samples, as well as a description of the clinical possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation. Publications on the use of these methods for visualization of thrombi in the left atrium and its appendage, in pulmonary vein ablation and occlusion of the left atrial appendage, as well as data on visualization of the residual flow around the occlusive device and thrombosis of intracardiac devices are presented. According to the results of a literature review, computed tomography and magnetic resonance imaging of the heart have similar or higher imaging capabilities compared to transesophageal echocardiography, as well as some advantages over it, primarily the non-invasiveness of the procedure. The works demonstrating the possibilities of computed tomography of the heart for the diagnosis of coronary heart disease in patients with atrial fibrillation are presented. In preparing the review, the literature search method in PubMed databases for the period 2013–2022 was used.

Компьютерную и магнитно-резонансную томографию сердца в последние годы широко применяют у пациентов с фибрилляцией предсердий. Их используют для определения морфологии сердца, наличия внутрисердечных тромбов, количественной оценки структур сердца, тромбозов внутрисердечных устройств, определения тактики при хирургических вмешательствах и других целей. Эти методы инструментальной диагностики можно использовать как альтернативу чреспищеводной эхокардиографии, которая имеет ряд ограничений и недостатков по сравнению с компьютерной и магнитно-резонансной томографией. Компьютерную и магнитно-резонансную томографию сердца применяют во избежание инвазивности при исследовании сердца, для повышения точности измерения структур сердца, снижения количества используемых методов диагностики перед различными хирургическими вмешательствами у пациентов с фибрилляцией предсердий, а также по эпидемическим показаниям в рамках профилактики распространения коронавирусной инфекции. Кроме того, магнитно-резонансная томография позволяет избежать лучевой нагрузки на пациента. В обзоре приведены результаты исследований, метаанализов объединённых выборок, а также описание клинических возможностей компьютерной и магнитно-резонансной томографии сердца у пациентов с фибрилляцией предсердий. Представлены работы по применению этих методов для визуализации тромбов левого предсердия и его ушка, при абляции лёгочных вен и окклюзии ушка левого предсердия, а также данные по визуализации остаточного потока вокруг окклюзирующего устройства и тромбоза внутрисердечных устройств. По результатам литературного обзора компьютерная томография и магнитно--резонансная томография сердца имеют сходные или более высокие визуализационные возможности в сравнении с чреспищеводной эхокардиографией, а также некоторые преимущества перед последней, в первую очередь, неинвазивность процедуры. Представлены работы, демонстрирующие возможности компьютерной томографии сердца для диагностики ишемической болезни сердца у пациентов с фибрилляцией предсердий. При подготовке обзора был использован метод поиска литературы по базам данных PubMed за период 2013–2022 гг.

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