Kauw Frans, Dankbaar Jan W, Habets Jesse, Cramer Maarten J M, de Jong Hugo W A M, Velthuis Birgitta K, Kappelle L Jaap
Department of Radiology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
Department of Cardiology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
Case Rep Neurol. 2018 May 30;10(2):118-123. doi: 10.1159/000489254. eCollection 2018 May-Aug.
This case report describes a patient who experienced a recurrent ischemic stroke within 24 h. Dual-energy computed tomography (DECT) angiography on admission showed 2 intracardiac thrombi, 1 in the left ventricle and 1 in the left atrial appendage. Following the second ischemic event, repeated DECT angiography showed that the ventricular thrombus had considerably diminished, suggesting that the recurrent brain infarction was caused by cardioembolism. This case emphasizes (1) the potential benefit of cardiac evaluation through CT angiography in the acute stroke setting, and (2) the use of DECT angiography for the detection of thrombus and the differentiation between thrombus, the myocardial wall, and a slow flow of contrast.
本病例报告描述了一名在24小时内发生复发性缺血性中风的患者。入院时的双能计算机断层扫描（DECT）血管造影显示有2个心内血栓，1个在左心室，1个在左心耳。第二次缺血事件后，重复的DECT血管造影显示心室血栓明显缩小，提示复发性脑梗死是由心源性栓塞引起的。本病例强调了（1）在急性中风情况下通过CT血管造影进行心脏评估的潜在益处，以及（2）使用DECT血管造影检测血栓以及区分血栓、心肌壁和造影剂缓慢流动的情况。
