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横断面影像学中的心血管表现:偶然和关键发现的范围及其对腹部放射科医生的临床意义。

Cardiovascular findings on cross-sectional imaging: spectrum of incidental and critical findings and clinical relevance for the abdominal radiologist.

机构信息

Department of Radiology, Duke University Medical Center, Durham, NC, USA.

Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

出版信息

Abdom Radiol (NY). 2019 Mar;44(3):1161-1180. doi: 10.1007/s00261-019-01922-7.

Abstract

Although not the primary focus of the exams, cardiovascular structures are included to some extent on all abdominal or whole-body cross-sectional studies. Cardiovascular findings often present incidentally and may range from chronic to acute and emergent pathologies. Among the most common cardiovascular findings are the presence of cardiac calcifications, most commonly coronary, which correlate with the presence of coronary artery and valvular disease. Signs of myocardial ischemia, both acute and chronic, and its complications may also be visualized. Cardiac filling defects most commonly represent thrombus and are associated with systemic arterial embolic complications. Pericardial findings often manifest as effusion or thickening, which may lead to hemodynamic consequences visible at imaging. Incidental pulmonary emboli and systemic venous thrombi may be incidentally detected, particularly in hospitalized and oncologic patients, and warrant immediate attention. This review will highlight the appearance of common and important incidental cardiovascular findings and related pitfalls and discuss reporting and follow-up recommendations relevant to the abdominal radiologist.

摘要

虽然不是检查的主要重点,但心血管结构在所有腹部或全身横断面研究中都有一定程度的包含。心血管的发现通常是偶然出现的,可能从慢性到急性和紧急病理不等。最常见的心血管发现包括心脏钙化的存在,最常见的是冠状动脉,这与冠状动脉和瓣膜疾病的存在相关。心肌缺血的急性和慢性表现及其并发症也可能被观察到。心脏充盈缺损最常见的代表血栓,与全身性动脉栓塞并发症相关。心包发现通常表现为积液或增厚,这可能导致影像学上可见的血流动力学后果。偶然发现的肺栓塞和体静脉血栓可能在住院和肿瘤患者中偶然发现,需要立即关注。这篇综述将重点介绍常见和重要的偶然心血管发现及其相关的陷阱,并讨论与腹部放射科医生相关的报告和随访建议。

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