心脏磁共振成像对钝性心脏损伤定性诊断的效能
Efficacy of cardiac magnetic resonance for the qualitative diagnosis of blunt cardiac injury.
作者信息
Kaneda Kazuhisa, Yamamura Hitoshi, Yamamoto Tomonori, Matsumoto Kenji, Ehara Shoichi, Mizobata Yasumitsu
机构信息
Department of Traumatology and Critical Care Medicine Osaka City University Osaka Japan.
Department of Cardiovascular Medicine Graduate of School of Medicine Osaka City University Osaka Japan.
出版信息
Acute Med Surg. 2015 Jun 15;3(1):53-56. doi: 10.1002/ams2.122. eCollection 2016 Jan.
CASE
A 47-year-old man was admitted after a car collision in shock with cardiac tamponade. After his circulation was stabilized by pericardial drainage, we treated him conservatively. Abnormal laboratory data and initial electrocardiogram (ECG) were suggestive of myocardial injury. However, echocardiography and cardiac computed tomography could not reveal the cause of the tamponade or the site of cardiac injury. ECG-gated cardiac magnetic resonance images were acquired.
OUTCOME
The cardiac magnetic resonance black-blood T2-weighted images showed hyperintense signals in the interventricular septum, whereas the late gadolinium enhancement images showed no enhancement in this region. We could accurately diagnose cardiac contusion of the anteroseptal area, which would explain the initial ECG abnormality seen in this patient.
CONCLUSION
Cardiac magnetic resonance imaging may be especially useful in the evaluation of non-operative management of blunt cardiac injury and could explain the initial ECG abnormality seen in our patient.
病例
一名47岁男性在车祸后因心脏压塞伴休克入院。经心包引流使循环稳定后，我们对他进行了保守治疗。异常的实验室数据和初始心电图（ECG）提示心肌损伤。然而，超声心动图和心脏计算机断层扫描未能揭示压塞的原因或心脏损伤的部位。采集了心电图门控心脏磁共振图像。
结果
心脏磁共振黑血T2加权图像显示室间隔高信号，而钆延迟增强图像显示该区域无强化。我们能够准确诊断前间隔区域的心脏挫伤，这可以解释该患者最初的心电图异常。
结论
心脏磁共振成像在钝性心脏损伤非手术治疗的评估中可能特别有用，并且可以解释我们患者最初的心电图异常。
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