Improving cardiovascular magnetic resonance access in low- and middle-income countries for cardiomyopathy assessment: rapid cardiovascular magnetic resonance.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Menacho Katia Devorha, Ramirez Sara, Perez Aylen, Dragonetti Laura, Perez de Arenaza Diego, Katekaru Diana, Illatopa Violeta, Munive Sara, Rodriguez Bertha, Shimabukuro Ana, Cupe Kelly, Bansal Rajiv, Bhargava Vivek, Rodriguez Ivonne, Seraphim Andreas, Knott Kris, Abdel-Gadir Amna, Guerrero Salomon, Lazo Marco, Uscamaita David, Rivero Marco, Amaya Neil, Sharma Sanjiv, Peix Amelia, Treibel Thomas, Manisty Charlotte, Mohiddin Sam, Litt Harold, Han Yuchi, Fernandes Juliano, Jacob Ron, Westwood Mark, Ntusi Ntobeko, Herrey Anna, Walker John Malcolm, Moon James
Аннотация
METHODS AND RESULTS: Rapid CMR focused particularly on CMP was implemented in 11 centres, 7 cities, 5 countries, and 3 continents linked to training courses for local professionals. Patients were followed up for 24 months to assess impact. The rate of subsequent adoption was tracked. Five CMR conferences were delivered (920 attendees-potential referrers, radiographers, reporting cardiologists, or radiologists) and five new centres starting CMR. Six hundred and one patients were scanned. Cardiovascular magnetic resonance indications were 24% non-contrast T2* scans [myocardial iron overload (MIO)] and 72% suspected/known cardiomyopathies (including ischaemic and viability). Ninety-eighty per cent of studies were of diagnostic quality. The average scan time was 22 ± 6 min (contrast) and 12 ± 4 min (non-contrast), a potential cost/throughput reduction of between 30 and 60%. Cardiovascular magnetic resonance findings impacted management in 62%, including a new diagnosis in 22% and MIO detected in 30% of non-contrast scans. Nine centres continued using rapid CMR 2 years later (typically 1-2 days per week, 30 min slots).
CONCLUSIONS: Rapid CMR of diagnostic quality can be delivered using available technology in LMICs. When embedded in care and a training programme, costs are lower, care is improved, and services can be sustained over time.