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Tầm quan trọng của hình ảnh tim mạch và não bộ ở trẻ em và thanh thiếu niên mắc Hội chứng viêm đa hệ thống ở trẻ em (MIS-C)
Tóm tắt
Hội chứng viêm đa hệ thống ở trẻ em (MIS-C) gần đây đã được báo cáo ở một số ít trẻ em bị ảnh hưởng bởi SARS-CoV-2, giống như bệnh Kawasaki (KD), một dạng viêm mạch hạng trung với nguyên nhân chưa rõ. Ngược lại với nhiễm COVID-19 cấp tính, thường nhẹ ở trẻ em, 68% bệnh nhân mắc MIS-C sẽ cần điều trị tại đơn vị chăm sóc tích cực. Viêm cơ tim và giãn động mạch vành/aneurysm là những biến chứng tim mạch chính trong MIS-C. Do đó, đánh giá lâm sàng chặt chẽ là cần thiết cả trong chẩn đoán và trong quá trình theo dõi. Siêu âm tim là phương pháp chủ chốt để đánh giá chức năng cơ tim và động mạch vành trong giai đoạn cấp tính. Cộng hưởng từ tim (CMR) phát hiện viêm cơ tim lan tỏa, bao gồm phù nề/ sẹo, tưới máu cơ tim và giải phẫu động mạch vành trong giai đoạn hồi phục, đặc biệt ở thanh thiếu niên, nơi siêu âm có thể cung cấp hình ảnh không đầy đủ. Tổn thương não trong MIS-C ít phổ biến hơn so với bệnh tim mạch. Tuy nhiên, điều này không phải là bất thường và nên được theo dõi thông qua đánh giá lâm sàng và cộng hưởng từ não (MRI), vì chúng ta vẫn chưa biết tác động của nó đối với sự phát triển não bộ. MRI não trong MIS-C cho thấy tổn thương sáng T2 liên quan đến khuếch tán hạn chế và tổn thương đối xứng vùng đồi thị. Kết luận, MIS-C là một bệnh đa hệ ảnh hưởng đến nhiều cơ quan quan trọng, chẳng hạn như tim và não. Sự nhận thức lâm sàng, ứng dụng các phương pháp hình ảnh công nghệ cao và các quy trình điều trị tiên tiến bao gồm thuốc hỗ trợ và chống viêm sẽ giúp bác sĩ ngăn chặn các biến chứng nghiêm trọng của MIS-C.
Từ khóa
#MIS-C #chẩn đoán #hình ảnh tim mạch #hình ảnh não bộ #COVID-19 #viêm cơ tim #siêu âm #cộng hưởng từ.Tài liệu tham khảo
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