Apter Sara, Shemesh Joseph, Raanani Pia, Portnoy Orith, Thaler Michael, Zissin Rivka, Ezra David, Rozenman Judith, Pfeffer Raphael, Hertz Marjorie
Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel.
Coron Artery Dis. 2006 Mar;17(2):145-51. doi: 10.1097/00019501-200603000-00008.
To study cardiovascular calcifications, detected by computed tomography, in patients following mediastinal radiation for Hodgkin lymphoma, and correlate them with clinical findings.
Fifteen patients, <or=55 years, with computed tomography detected cardiovascular calcifications after mediastinal radiotherapy for Hodgkin lymphoma were identified during a 10-year period. Calcifications were evaluated for site and extent and were correlated with clinical data including symptoms and signs of heart disease, angiographic and surgical findings.
Accelerated calcifications were detected in the coronary arteries (n=11), in the aorta (n=11), and in the aortic valve and the mitral apparatus (n=8). Calcifications were more extensive when radiation was given at a young age. Clinical evidence of cardiovascular disease included coronary events in three patients, valvular dysfunction in two, pericarditis in two and complete atrioventricular block in one. Seven patients had no cardiac symptoms.
Early cardiovascular calcifications can be radiation associated. Such calcifications may represent radiation-induced atherosclerosis and can be detected by computed tomography even in asymptomatic patients. The implication of our findings is that spiral computed tomography may serve as a non-invasive modality to detect accelerated cardiovascular calcifications in high-risk asymptomatic patients who survived Hodgkin lymphoma.
研究接受纵隔放疗的霍奇金淋巴瘤患者经计算机断层扫描检测到的心血管钙化情况，并将其与临床 findings 相关联。
在 10 年期间，确定了 15 例年龄≤55 岁、在接受霍奇金淋巴瘤纵隔放疗后经计算机断层扫描检测到心血管钙化的患者。对钙化的部位和范围进行评估，并与包括心脏病症状和体征、血管造影和手术 findings 在内的临床数据相关联。
在冠状动脉（n = 11）、主动脉（n = 11）以及主动脉瓣和二尖瓣装置（n = 8）中检测到加速钙化。年轻时接受放疗，钙化范围更广泛。心血管疾病的临床证据包括 3 例患者发生冠状动脉事件、2 例瓣膜功能障碍、2 例心包炎和 1 例完全性房室传导阻滞。7 例患者无心脏症状。
早期心血管钙化可能与放疗有关。此类钙化可能代表放疗诱导的动脉粥样硬化，即使在无症状患者中也可通过计算机断层扫描检测到。我们研究结果的意义在于，螺旋计算机断层扫描可作为一种非侵入性方法，用于检测霍奇金淋巴瘤存活的高危无症状患者中的加速心血管钙化。
