Abstract: Myocarditis refers to the inflammatory injury of myocardial tissue caused by various reasons. The clinical manifestations of myocarditis are nonspecific and vary greatly. At present， the diagnosis of myocarditis mainly depends on auxiliary examinations， such as electrocardiogram， serological indicators， and echocardiography， but these examinations are limited in sensitivity and specificity， and have limited value in risk stratification. Cardiac magnetic resonance imaging （CMR） can detect pathological changes in the myocardium early， and has become the gold standard for evaluating such changes as myocardial congestion， necrosis， fibrous scars， and myocardial activity. It is strongly associated with adverse cardiovascular events， including cardiac function deterioration， heart failure， arrhythmia， cardiac arrest， and even cardiovascular death or all cause death. Therefore， rational application of CMR is helpful to the risk stratification of children with myocarditis.

Key words: child, myocarditis, cardiac magnetic resonance, risk stratification, expert consensus

摘要： 心肌炎是指各种原因导致的心肌组织的炎性损伤，病因较多，感染是最主要的病因。心肌炎临床表现无特异性，且变化较大。目前，心肌炎诊断主要依赖心电图、血清学指标、超声心动图等辅助检查，但这些检查灵敏度有限，特异性低，对儿童心肌炎的危险分层价值有限。心脏磁共振成像（CMR）能够早期发现心肌病理改变，已成为评价心肌充血渗出、坏死、纤维瘢痕和心肌活性等改变的金标准，CMR表现与心功能恶化、心力衰竭、心律失常、心脏骤停，甚至心血管死亡或全因死亡等不良心血管事件显著相关。因此，合理应用CMR有助于心肌炎患儿的危险分层。

关键词: 儿童, 心肌炎, 心脏磁共振, 危险分层, 专家共识