生理性心脏脂肪浸润和心肌梗死的CT鉴别诊断

吴开东

doi:10.13201/j.issn.1001-1439.2014.02.018

生理性心脏脂肪浸润和心肌梗死的CT鉴别诊断

吴开东^,

- 临沂市平邑县中医院放射科(临沂, 273300)

详细信息

通讯作者: 吴开东,E-mail:sdwkd8096@163.com

中图分类号: R541.4

收稿日期: 2012-12-21

修回日期: 2013-03-01

Differential diagnosis between pathologic fatty infiltration and myocardial infarction in MSCT

WU Kaidong^,

- Department of Radiology, Traditional Hospital in Pingyi of Linyi City, Linyi, Shandong, 273300, China

More Information

Corresponding author: WU Kaidong, E-mail: sdwkd8096@163.com

Received Date: 21 December 2012

Revised Date: 01 March 2013

摘要

摘要: 目的:利用多层螺旋CT研究生理性心脏脂肪浸润分布特征, 并与心肌梗死对比, 探讨两者的CT鉴别诊断方法。方法:回顾性分析冠状动脉CT造影发现的心脏生理性脂肪浸润者258例, 进行后处理多平面重建观察心肌脂肪浸润形态特点和分布规律。结果:生理性脂肪浸润者平扫和增强扫描确定的脂性密度区在心脏中的分布按照出现频率为:右室游离壁 (183/258, 71%)、右心室肌小梁 (178/258, 69%)、右心室节制索 (101/258, 39%)、左心室肌小梁 (90/258, 35%)、左心室心尖部 (72/258, 28%)、室间隔右心室面 (67/258, 26%)、室间隔左心室面 (31/258, 12%)、左心室肌小梁 (13/258, 5%)。累及右心室壁者, 室壁平均厚度3.3 (2.1⁹.5) mm, 与年龄呈正相关 (r=0.624 5, P<0.05), 无性别差异;厚度 ≤ 4 mm者185例 (72.3%), >4 mm者80例 (27.7%)。心肌梗死患者34例, 其中28例为陈旧性心肌梗死, 其脂肪分布各具一定特征性。结论:心脏脂肪浸润的形态特征和分布情况有助于生理性脂肪浸润和心肌梗死的鉴别诊断。
- 心肌梗死 /
- 脂肪浸润 /
- 右心室 /
- 体层摄影术 /
- X线计算机
Abstract: Objective: To assess the manifestations of the pathologic fatty infiltration and myocardial infarction in MSCT cardiac imaging.Method: The morphological characteristics and distribution pattern of pathologic fatty infiltration in the multiplanar reconstructive MSCT images of 258patients with pathologic fatty infiltration proved by coronary topographic angiography or right ventriculography were respectively analyze.Result: The distribution pattern in 258cases were as follows:the RV wall (183/258, 71%) RV trabeculae (178/258, 69%), RV moderator band (101/258, 39%), LV trabeculae (90/258, 35%), LV apex (72/258, 28%), RV side of the septum (67/258, 26%), LV side of the septum (31/258, 12%), LV papillary muscle (13/258, 5%).The RV thickness of 265cases with RV fatty infiltration were 3.3 (2.1⁹.5) mm which were positively correlated with age (r=0.624 5, P<0.05).All 34cases were myocardial infarction, 28of them were healed myocardial infarction.Conclusion: The morphological characteristics and distribution pattern of cardiac fat can help to differentiate the physiologic and pathologic fatty infiltration.
- myocardial infarction /
- fatty infiltration /
- right ventricle /
- tomography /
- X-ray computed

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参考文献(8)

[1]	KIMURA F, MATSUO Y, NAKAJIMA T, et al.Myocardial fat at cardiac imaging:how can we differentiate pathologic from physiologic fatty infiltration?[J].Radiographics, 2010, 30:1587-1602.
[2]	TANSEY D K, ALY Z, SHEPPARD M N.Fat in the right ventricle of the normal heart[J].Histopathology, 2005, 46:98-104.
[3]	BASSO C, THIENE G.Adipositas cordis, fatty infiltration of the right ventricle, and arrhythmogenic right ventricular cardiomyopathy.Just a matter of fat?[J].Cardiovasc Pathol, 2005, 14:37-41.
[4]	LORIN DE LA GRANDMAISON G, LE BIHAN C, DURIGON M.Assessment of right ventricular lipomatosis by histomorphometry in control adult autopsy cases[J].Int J Legal Med, 2001, 115:105-108.
[5]	IMADA M, FUNABASHI N, ASANO M, et al.Epidemiology of fat replacement of the right ventricular myocardium determined by multislice computed tomography using a logistic regression model[J].Int J Cardiol, 2007, 119:410-413.
[6]	WINER-MURAM H T, TANN M, AISEN A M, et al.Computed tomography demonstration of lipomatous metaplasia of the left ventricle following myocardial infarction[J].J Comput Assist Tomogr, 2004, 28:455-458.
[7]	ZAFAR H M, LITT H I, TORIGIAN D A.CT imaging features and frequency of left ventricular myocardial fat in patients with CT findings of chronic left ventricular myocardial infarction[J].Clin Radiol, 2008, 63:256-262.
[8]	毛定飚, 滑炎卿, 张国桢.心肌梗死的多层螺旋CT表现[J].放射学实践, 2007, 22 (4):411-414.