Raney Aidan R, Saremi Farhood, Kenchaiah Satish, Gurudevan Swaminatha V, Narula Jagat, Narula Navneet, Channual Stephanie
Department of Radiologic Sciences, University of California, Irvine, Orange, CA 92868-3298, USA.
J Cardiovasc Comput Tomogr. 2008 May-Jun;2(3):152-63. doi: 10.1016/j.jcct.2008.01.004. Epub 2008 Jan 31.
Intramyocardial fat deposition occurs as an age-related process and in multiple pathologic processes.
We evaluated the presence of left ventricular (LV) and right ventricular (RV) intramyocardial fat with 64-slice multidetector computed tomography (MDCT).
One hundred persons with no history of coronary artery disease (47 women, 53 men; mean age [+/- SD], 53 +/- 12.2 years) and 25 patients with CT findings of myocardial infarction (17 men, 8 women; mean age, 71.3 +/- 9.6 years) were studied for intramyocardial fat in defined segments of the ventricles (17 LV and 10 RV segments) at 3 levels. Fat deposition was defined as density range of -30 to -190 Hounsfield units on images both before and after contrast.
In healthy persons, LV intramyocardial fat was primarily located in the basal segments (5% anteroseptal, 5% inferior), and RV intramyocardial fat was primarily located in the anterolateral (24% of base, 23% of mid) and inferolateral (27% base, 27% mid) segments. Older age was associated with an increased odds of RV (sex-adjusted odds ratio [OR] per decade increment, 1.61; 95% confidence interval [CI], 1.11-2.33; P = 0.012) but not LV (OR, 0.97; 95% CI, 0.67-1.40; P = 0.85) intramyocardial fat. Compared with women, men had a lower risk of LV (95% CI, 0.1-0.64; P = 0.004) but not RV (95% CI, 0.35-1.87; P = 0.62) intramyocardial fat. Patients with old myocardial infarction (>3 years) had increased percentage of fat in infarcted left ventricles at all 3 levels (P <or= 0.004).
Intramyocardial fat can be detected by MDCT and is common in healthy and infarcted myocardium.
心肌内脂肪沉积是一个与年龄相关的过程，也发生于多种病理过程中。
我们采用64层多排螺旋计算机断层扫描（MDCT）评估左心室（LV）和右心室（RV）心肌内脂肪的存在情况。
对100例无冠心病病史的人（47名女性，53名男性；平均年龄[±标准差]，53±12.2岁）和25例CT检查发现有心肌梗死的患者（17名男性，8名女性；平均年龄，71.3±9.6岁）进行研究，观察心室特定节段（17个左心室节段和10个右心室节段）3个层面的心肌内脂肪情况。脂肪沉积定义为增强前后图像上-30至-190亨氏单位的密度范围。
在健康人中，左心室心肌内脂肪主要位于基底部节段（前间隔5%，下壁5%），右心室心肌内脂肪主要位于前外侧（基底部24%，中间段23%）和下外侧（基底部27%，中间段27%）节段。年龄较大与右心室心肌内脂肪增加的几率相关（按性别调整后，每增加十岁的优势比[OR]为1.61；95%置信区间[CI]，1.11 - 2.33；P = 0.012），而与左心室心肌内脂肪无关（OR，0.97；95% CI，0.67 - 1.40；P = 0.85）。与女性相比，男性左心室心肌内脂肪风险较低（95% CI，0.1 - 0.64；P = 0.004），但右心室心肌内脂肪风险无差异（95% CI，0.35 - 1.87；P = 0.62）。陈旧性心肌梗死（>3年）患者梗死的左心室在所有3个层面的脂肪百分比均增加（P≤0.004）。
MDCT可检测到心肌内脂肪，其在健康心肌和梗死心肌中均常见。
