多层计算机断层扫描检测心肌梗死后患者的脂肪组织。
Adipose tissue detected by multislice computed tomography in patients after myocardial infarction.
作者信息
Ichikawa Yasutaka, Kitagawa Kakuya, Chino Shuji, Ishida Masaki, Matsuoka Koji, Tanigawa Takashi, Nakamura Tomoaki, Hirano Tadanori, Takeda Kan, Sakuma Hajime
机构信息
Department of Radiology, Matsusaka Central Hospital, Mie, Japan.
出版信息
JACC Cardiovasc Imaging. 2009 May;2(5):548-55. doi: 10.1016/j.jcmg.2009.01.010.
OBJECTIVES
Our aim was to investigate the frequency of left ventricular (LV) and right ventricular adipose tissue on multislice computed tomography (CT) in patients with a history of myocardial infarction (MI) and to determine correlations with infarct age.
BACKGROUND
Fat deposition in the ventricular wall has frequently been observed in post-infarct myocardial tissue. However, the in vivo relevance of adipose tissue in MI on CT and correlations with infarct age have not been determined.
METHODS
Fifty-three patients with a history of MI (mean age 66 +/- 10 years; 38 men, 15 women) and 63 subjects with no history of MI or coronary revascularization (mean age 65 +/- 12 years; 37 men, 26 women) were retrospectively studied for intramyocardial fat on 64-slice cardiac CT. Presence or absence, distribution, and correlations with infarct age of LV adipose tissue were evaluated.
RESULTS
Compared with noninfarct control subjects, the MI group showed a significantly higher prevalence of fat deposition within LV myocardium on CT (MI group, 62% [33 of 53] vs. control group, 3% [2 of 63]; p < 0.0001). In 32 of 33 patients (97%) with MI and LV fat deposition on CT, adipose tissue was observed in the region perfused by the infarct-related artery and was located in the subendocardium in 30 patients (94%), the middle layer in 1 patient (3%), and the subepicardium in 1 patient (3%). Mean infarct age was significantly higher in patients with LV adipose tissue (8.2 +/- 4.4 years) than in those without adipose tissue (2.2 +/- 2.6 years, p < 0.001). Thirty of 35 patients (89%) with infarct age >or=3 years showed adipose tissue in MI. Conversely, none of 9 patients with infarct age <10 months showed fatty replacement.
CONCLUSIONS
Myocardial adipose tissue is common in patients with infarct age >or=3 years. CT evaluation of myocardial adipose tissue may be important for accurate interpretation of CT perfusion and infarct imaging of the heart.
目的
我们的目的是研究心肌梗死（MI）病史患者多层螺旋计算机断层扫描（CT）上左心室（LV）和右心室脂肪组织的频率，并确定与梗死年龄的相关性。
背景
梗死心肌组织中经常观察到心室壁脂肪沉积。然而，CT上MI中脂肪组织的体内相关性以及与梗死年龄的相关性尚未确定。
方法
回顾性研究53例有MI病史的患者（平均年龄66±10岁；38例男性，15例女性）和63例无MI或冠状动脉血运重建病史的受试者（平均年龄65±12岁；37例男性，26例女性），通过64层心脏CT检查心肌内脂肪。评估LV脂肪组织的存在与否、分布及其与梗死年龄的相关性。
结果
与非梗死对照组相比，MI组CT上LV心肌内脂肪沉积的患病率显著更高（MI组，62%[53例中的33例] vs.对照组，3%[63例中的2例]；p<0.0001）。在33例CT上有MI和LV脂肪沉积的患者中，32例（97%）在梗死相关动脉灌注区域观察到脂肪组织，30例（94%）位于心内膜下，1例（3%）位于中层，1例（3%）位于心外膜下。有LV脂肪组织的患者平均梗死年龄（8.2±4.4岁）显著高于无脂肪组织的患者（2.2±2.6岁，p<0.001）。35例梗死年龄≥3年的患者中，30例（89%）在MI中显示有脂肪组织。相反，9例梗死年龄<10个月的患者均未显示脂肪替代。
结论
梗死年龄≥3年的患者心肌脂肪组织常见。CT评估心肌脂肪组织可能对准确解读心脏CT灌注和梗死成像很重要。
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