Heyer Christoph M, Kagel Thomas, Lemburg Stefan P, Bauer Torsten T, Nicolas Volkmar
Institute of Radiology and Nuclear Medicine, BG Kliniken Bergmannsheil, Ruhr-University of Bochum, Bürkle-de-la-Camp Platz 1, D-44789 Bochum, Germany.
Chest. 2003 Dec;124(6):2068-73. doi: 10.1378/chest.124.6.2068.
Lipomatous hypertrophy of the interatrial septum (LHIS) is a benign disorder characterized by fat accumulation in the interatrial septum. It typically occurs in elderly, obese patients and may cause arrhythmia.
The purpose of this study was to determine the imaging features of this cardiac pathology using multislice CT (MSCT), and its relationship with clinical findings.
A total of 1,292 consecutive patients who underwent MSCT of the thorax from September 2001 to August 2002 were prospectively studied. Beside the analysis of patient records, the amount of fat in the interatrial septum, and its size and shape were determined.
Among the 1,292 patients investigated, we found 28 (2.2%) with LHIS. The mean age of affected patients was 72.2 years. MSCT studies revealed a mass of fat attenuation with sharp margins and sparing of the fossa ovalis, resulting in a dumbbell shape in all patients. The median thickness of the interatrial septum was 32 mm (range, 20 to 62 mm), and the median craniocaudal extend was 62 mm (range, 51 to 89 mm). Twenty-one patients (75.0%) showed increased epicardial fat, 18 patients (64.3%) had significant pulmonary emphysema, and 13 of 21 patients (61.9%) showed ECG abnormalities. Three patients underwent functional cardiac MRI studies. In one patient, hemodynamic obstruction by LHIS was shown.
MSCT scanning is a useful method to diagnose LHIS, a cardiac condition that in our series reached a 2.2% incidence. The lesion shows characteristic features, thus differentiating it from other cardiac tumors. Advanced age, obesity, pulmonary emphysema, and atrial arrhythmias are common additional findings in patients with LHIS.
房间隔脂肪肥厚（LHIS）是一种良性疾病，其特征为房间隔内脂肪堆积。它通常发生于老年肥胖患者，可能导致心律失常。
本研究旨在利用多层螺旋CT（MSCT）确定这种心脏病变的影像学特征及其与临床发现的关系。
对2001年9月至2002年8月间连续1292例行胸部MSCT检查的患者进行前瞻性研究。除分析患者记录外，还确定了房间隔内的脂肪量及其大小和形状。
在1292例接受调查的患者中，我们发现28例（2.2%）患有LHIS。受影响患者的平均年龄为72.2岁。MSCT研究显示，脂肪衰减肿块边界清晰，卵圆窝未受累，所有患者均呈哑铃形。房间隔的中位厚度为32mm（范围20至62mm），头足向中位长度为62mm（范围51至89mm）。21例患者（75.0%）表现为心外膜脂肪增加，18例患者（64.3%）有明显肺气肿，21例患者中有13例（61.9%）出现心电图异常。3例患者接受了心脏功能MRI研究。其中1例患者显示LHIS导致血流动力学障碍。
MSCT扫描是诊断LHIS的一种有用方法，在我们的系列研究中，这种心脏疾病的发病率为2.2%。该病变具有特征性表现，可与其他心脏肿瘤相鉴别。高龄、肥胖、肺气肿和房性心律失常是LHIS患者常见的其他表现。
