Dellegrottaglie Santo, Pedrotti Patrizia, Pedretti Stefano, Mauri Francesco, Roghi Alberto
Cardiac MR Unit, A. De Gasperis Department of Cardiology, Niguarda-Ca' Granda Hospital, Milan, Italy.
J Cardiovasc Med (Hagerstown). 2008 Nov;9(11):1177-9. doi: 10.2459/JCM.0b013e328306f300.
Cardiac contusion is a potential complication of blunt chest trauma and can be detected in a variable percentage of cases, depending on the method of diagnosis employed. Mechanical and/or ischemic mechanisms may be involved in the occurrence of myocardial injury in patients with cardiac contusion. In the reported case, cardiac magnetic resonance (CMR) was performed late after chest trauma in a 17-year-old man involved in a car accident 4 years earlier. CMR images documented the persistence of severe regional dysfunction involving the left ventricle, associated with a large area of post-contrast myocardial enhancement (representing necrosis and/or fibrosis). Functional and morphologic information derived from CMR appears theoretically to be helpful in defining the nature and severity of myocardial involvement at presentation, as well as during follow-up of patients with cardiac contusion.
心脏挫伤是钝性胸部创伤的一种潜在并发症,根据所采用的诊断方法,在不同比例的病例中均可检测到。心脏挫伤患者发生心肌损伤可能涉及机械和/或缺血机制。在本报告的病例中,一名17岁男性在4年前遭遇车祸,胸部创伤后很晚才进行了心脏磁共振成像(CMR)检查。CMR图像记录了左心室严重局部功能障碍的持续存在,并伴有大面积造影剂增强后的心肌强化(代表坏死和/或纤维化)。理论上,从CMR获得的功能和形态学信息有助于确定心脏挫伤患者就诊时以及随访期间心肌受累的性质和严重程度。