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多排螺旋 CT 对心肌梗死并发症的诊断

Complications of myocardial infarction on multidetector-row computed tomography of chest.

机构信息

Department of Radiology, Papworth and Addenbrookes Hospital, Cambridge, UK.

出版信息

Clin Radiol. 2010 Nov;65(11):930-6. doi: 10.1016/j.crad.2010.03.017. Epub 2010 Aug 4.

Abstract

Myocardial infarction (MI) secondary to coronary artery disease remains the leading cause of death in the western world. The advent of early reperfusion therapy has substantially decreased in-hospital mortality and has improved the outcome in survivors of the acute phase of MI. Complications of MI include ischaemic, mechanical, arrhythmic, embolic and inflammatory disturbances. Although some of these complications may be infrequent, their importance is underscored because of the potential ability to correct them with early diagnosis and appropriate treatment. The majority of these complications will be detected on clinical examination and confirmed by echocardiography. Some patients may undergo non-electrocardiogram (ECG)-gated thoracic multidetector-row computed tomography (MDCT) due to non-specific presentation. In this group, it is imperative for the radiologist to be aware of and be confident in diagnosing the complications secondary to MI. This review illustrates the spectrum and imaging features of acute and chronic complications of MI that can be visualized on both ECG-gated cardiac and non-ECG-gated thoracic MDCT.

摘要

由于冠状动脉疾病导致的心肌梗死(MI)仍然是西方世界的主要死亡原因。早期再灌注治疗的出现大大降低了住院死亡率,并改善了 MI 急性期幸存者的预后。MI 的并发症包括缺血、机械、心律失常、栓塞和炎症紊乱。尽管其中一些并发症可能不常见,但由于早期诊断和适当治疗有可能纠正这些并发症,因此其重要性更加突出。这些并发症中的大多数将通过临床检查发现,并通过超声心动图确认。由于非特异性表现,一些患者可能会接受非心电图门控胸部多排螺旋 CT(MDCT)检查。在这一组中,放射科医生必须意识到并有信心诊断继发于 MI 的并发症。这篇综述说明了可以在心电图门控心脏和非心电图门控胸部 MDCT 上观察到的 MI 的急性和慢性并发症的范围和影像学特征。

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