van Driest F Y, Hertgers O, Scholte A J H A, Jukema J W, de Graaf M A
Department of Cardiology, Leiden Heart-Lung Center, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Radiol Case Rep. 2022 Mar 24;17(5):1734-1736. doi: 10.1016/j.radcr.2022.03.019. eCollection 2022 May.
Chest computed tomography (CT) is not routinely used for the diagnosis of myocardial infarction. However, there have been some reports of patients undergoing chest CT for other indications in which ultimately MI was diagnosed due to the presence of areas of myocardial hypoperfusion. The authors present the case of a 60-years old male who is referred due to acute chest pain radiating between the scapulae. Thoracic computed tomography angiography to rule out an aortic dissection revealed an occlusion of the left anterior descending coronary artery with an area of relative hypoperfusion. Hence, the present case demonstrates how using routine thoracic computed tomography angiography, transmural ischemia can be visualized in the setting of an acute myocardial infarction. It should make clinicians aware of the fact it may be beneficial to look for myocardial perfusion abnormalities when assessing chest CT's.
胸部计算机断层扫描(CT)通常不用于诊断心肌梗死。然而,有一些关于患者因其他指征接受胸部CT检查的报告,这些患者最终因存在心肌灌注不足区域而被诊断为心肌梗死。作者介绍了一名60岁男性的病例,该患者因急性胸痛放射至肩胛间区而前来就诊。为排除主动脉夹层而进行的胸部计算机断层扫描血管造影显示左前降支冠状动脉闭塞,并伴有相对灌注不足区域。因此,本病例表明,在急性心肌梗死的情况下,使用常规胸部计算机断层扫描血管造影可以观察到透壁性缺血。这应使临床医生意识到,在评估胸部CT时寻找心肌灌注异常可能是有益的。