Park Eun-Ah, Lee Whal, Na Sang-Hoon, Chung Jin Wook, Park Jae Hyung
SNU-Duke Cardiovascular MR Research Center, Seoul National University, Seoul, Korea.
Department of Radiology, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, Korea.
Int J Cardiovasc Imaging. 2013 Jun;29(Suppl 1):37-45. doi: 10.1007/s10554-013-0243-5. Epub 2013 Jun 25.
To analyze computed tomography (CT) characteristics of left ventricle (LV) fat deposition in patients without proven myocardial disease and to correlate these CT findings with electrocardiogram (ECG) and echocardiography data. We retrospectively searched our database of 14,470 consecutive coronary CT scans performed in the past 4 years for LV fat deposition in patients without proven myocardial disease. In total, we identified 25 patients (0.2 %; 10 males, 15 females; mean age 63 years) involving 91 cardiac segments. Pattern and location of LV fat deposition on CT were analyzed and compared to ECG and echocardiographic data. LV fat deposition can be categorized into 3 patterns: fat deposits in an apical cap (pattern I, n = 14), localized fat accumulation (pattern II, n = 12), and diffuse linear accumulation (pattern III, n = 6). Both patterns I and II were seen in 7 patients. The most common locations were apical segments (40 %) and the mid-myocardial layer (70 %). No patients had ECG findings positive for left-dominant arrhythmogenic dysplasia. Regional wall-motion abnormalities and decreased LV function (ejection fraction < 50 %) were only observed in 33 % of pattern III cases. LV fat deposition on CT can be seen in patients without proven myocardial disease. LV fat depositions were most commonly seen in the mid-myocardial location and apical segments. Diffuse linear fat deposition in the LV may correlates with decreased regional and global function.
分析无确诊心肌疾病患者左心室(LV)脂肪沉积的计算机断层扫描(CT)特征,并将这些CT表现与心电图(ECG)和超声心动图数据相关联。我们回顾性检索了过去4年连续进行的14470例冠状动脉CT扫描数据库,以查找无确诊心肌疾病患者的LV脂肪沉积情况。总共,我们识别出25例患者(0.2%;男性10例,女性15例;平均年龄63岁),涉及91个心脏节段。分析CT上LV脂肪沉积的模式和位置,并与ECG和超声心动图数据进行比较。LV脂肪沉积可分为3种模式:心尖帽状脂肪沉积(模式I,n = 14)、局限性脂肪堆积(模式II,n = 12)和弥漫性线性堆积(模式III,n = 6)。7例患者同时出现模式I和模式II。最常见的位置是心尖节段(40%)和心肌中层(70%)。没有患者的ECG表现为左优势型致心律失常性发育异常阳性。仅在33%的模式III病例中观察到节段性室壁运动异常和LV功能降低(射血分数<50%)。在无确诊心肌疾病的患者中可看到CT上的LV脂肪沉积。LV脂肪沉积最常见于心肌中层位置和心尖节段。LV内弥漫性线性脂肪沉积可能与节段性和整体功能降低相关。