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。