心脏CT纳入Takotsubo综合征诊断路径的现状与展望

Takotsubo syndrome (TS) is an acute and reversible form of myocardial dysfunction that often mimic acute coronary syndrome. Imaging plays a pivotal role in the diagnostic work-up of patients with suspected TS, allowing a comprehensive assessment of myocardial function and tissue abnormalities. Among non-invasive imaging modalities, cardiac magnetic resonance (CMR) has emerged as the reference standard for TS evaluation, providing detailed insights into ventricular function and tissue characterization, and identifying the hallmark features of the syndrome. However, CMR may be contraindicated or limited in several clinical scenarios, including device incompatibility, claustrophobia, arrhythmia- or motion-related image degradation, and restricted availability. In this context, cardiac computed tomography (CCT) is rapidly evolving from a purely anatomical tool to a comprehensive imaging platform capable of integrating coronary evaluation with functional and tissue characterization. A structured literature search was performed using PubMed, MEDLINE via Ovid, Scopus, and the Cochrane Library to identify peer-reviewed studies published from 2020 onwards, focusing on the role of CCT beyond coronary artery assessment, including morphological, functional, strain, and tissue characterization, particularly in patients with TS. This review summarizes current evidence supporting the role of CCT in the assessment of patients with suspected TS, discusses its clinical strengths and limitations, and highlights emerging technological advances. Furthermore, we propose a potential diagnostic workflow incorporating CCT within the multimodal imaging approach to TS and outline possible CCT-based diagnostic criteria to enhance the non-invasive identification of this complex condition.