通过心电图门控多层计算机断层扫描诊断出的心脏内脂肪灶：频率与形态
Fatty foci within the heart diagnosed with ECG-gated multi-slice computed tomography: frequency and morphology.
作者信息
Tomaszewska Monika, Czekajska-Chehab Elzbieta, Olchowik Grażyna, Tomaszewski Marek, Drop Andrzej
机构信息
1st Department of Radiology, Medical University of Lublin, Lublin, Poland.
Department of Biophysics, Medical University of Lublin, Lublin, Poland.
出版信息
Med Sci Monit. 2014 May 21;20:833-42. doi: 10.12659/MSM.890271.
BACKGROUND
The purpose of our study was to analyze the frequency of focal fatty replacement (FR) of the heart, as well as the distribution and detailed morphology of FR in a large group of patients referred to multi-slice computed tomography with ECG-gating examinations (ECG-MSCT) for various clinical reasons.
MATERIAL AND METHODS
The ECG-MSCT examinations of 1830 consecutive patients were analyzed. The examinations were performed using 8-row (1015 patients) and 64-row (815 patients) MSCT, in pre- and post-contrast scanning. We analyzed the morphology of FR, the dimensions and densities of changes, as well as the morphology and localization of FR with regard to clinical diagnosis.
RESULTS
204 subjects (11.1%) had FR within the heart (113 men; 91 women; mean age 57.8 years); 66% of fatty foci were seen only in the native scanning. The distribution of the fat was: right ventricle (RV) 31.9%, left ventricle (LV) 21.5%, biventricular 39.7%, interventricular or atrial septum 5.9%, and atria 1%. In the RV, fat was localized mainly in the papillary muscles, while in the LV fat was mainly subendocardial (p<0.001). The morphology of the fat was: linear 61.6%, oval 14.8%, punctuate 10.6%, irregular 10.2%, and bilobular 2.8%. Fat was primarily located subendocardially in the LV in patients after myocardial infarction. In patients with suspected coronary artery disease, it was mainly observed subpericardially in the RV and in papillary muscles (p<0.001).
CONCLUSIONS
The incidental frequency of FR within the heart in patients diagnosed with the ECG-MSCT examinations is about 11%. Pre-contrast scanning is the most valuable for FR assessment.
背景
我们研究的目的是分析心脏局灶性脂肪替代（FR）的发生率，以及在因各种临床原因接受心电图门控多层螺旋CT检查（ECG-MSCT）的一大组患者中，FR的分布和详细形态。
材料与方法
分析了1830例连续患者的ECG-MSCT检查结果。检查使用8排（1015例患者）和64排（815例患者）MSCT进行，包括造影前和造影后扫描。我们分析了FR的形态、病变的大小和密度，以及与临床诊断相关的FR的形态和定位。
结果
204例受试者（11.1%）心脏内存在FR（男性113例；女性91例；平均年龄57.8岁）；66%的脂肪灶仅在平扫时可见。脂肪分布情况为：右心室（RV）31.9%，左心室（LV）21.5%，双心室39.7%，室间隔或房间隔5.9%，心房1%。在右心室，脂肪主要位于乳头肌，而在左心室，脂肪主要位于心内膜下（p<0.001）。脂肪形态为：线状61.6%，椭圆形14.8%，点状10.6%，不规则形10.2%，双叶形2.8%。心肌梗死后患者的脂肪主要位于左心室心内膜下。在疑似冠心病患者中，主要在右心室的心包下和乳头肌中观察到脂肪（p<0.001）。
结论
经ECG-MSCT检查诊断的患者中，心脏内FR的偶然发生率约为11%。平扫对FR评估最有价值。
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