Department of Cardiovascular Imaging, Instituto Medico ENERI, Clinica La Sagrada Familia, Buenos Aires, Argentina.
Stroke Unit, Instituto Medico ENERI, Clinica La Sagrada Familia, Buenos Aires, Argentina.
Rev Cardiovasc Med. 2021 Mar 30;22(1):51-65. doi: 10.31083/j.rcm.2021.01.215.
The complex and reciprocal relationship between the brain and the heart has gained increasing attention under the concept of neurocardiology. Myocardial injury is common in cerebrovascular disease, and cardiovascular complications are the second leading cause of death after stroke. Cardiac computed tomography (CT) is a fast and reliable non-invasive tool for the assessment of cardioembolic sources. Compared to single energy CT, spectral/dual energy cardiac CT improves tissue characterization and also leads to significant reductions in contrast volume. In this review article, we portray the potential clinical applications of spectral CT in neurocardiology, focusing in the enhanced diagnosis of cardioembolic sources and cardiovascular risk assessment of patients with stroke, including improved detection of thrombus, identification of subtle myocardial disease, and pulmonary complications within the same session.
在神经心脏病学概念下,大脑和心脏之间复杂且相互的关系受到了越来越多的关注。心肌损伤在脑血管疾病中很常见,心血管并发症是中风后死亡的第二大原因。心脏计算机断层扫描(CT)是评估心源性栓子的快速可靠的非侵入性工具。与单能量 CT 相比,能谱/双能心脏 CT 可改善组织特征,还可显著减少对比剂用量。在这篇综述文章中,我们描述了能谱 CT 在神经心脏病学中的潜在临床应用,重点是增强心源性栓子的诊断以及中风患者的心血管风险评估,包括提高对血栓的检测、细微心肌疾病的识别以及同一检查中肺部并发症的识别。