Aydin Fahri, Kantarci Mecit, Aydın Sonay, Karavaş Erdal, Ceyhun Gökhan, Ogul Hayri, Şahin Çağrı Emin, Eren Suat
Department of Radiology, Ataturk University, Erzurum 25000, Turkey.
Department of Radiology, Erzincan Binali Yidirim University, Erzincan 24000, Turkey.
World J Clin Cases. 2023 Feb 16;11(5):1031-1039. doi: 10.12998/wjcc.v11.i5.1031.
No study on dual energy computed tomography (DECT) has been found in the literature to evaluate possibly fatal cardiac/myocardial problems in corona virus disease 2019 (COVID-19) patients. Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion, and these deficits can be shown DECT with a perfect interrater agreement.
To assess lung perfusion alterations in COVID-19 patients. To our knowledge, no study using DECT has been performed to evaluate possibly fatal cardiac/ myocardial problems in COVID-19 patients. The purpose of this study is to evaluate the role of DECT in the detection of COVID-19-related cardiac diseases.
Two blinded independent examiners evaluated CT images using the 17-segment model according to the American Heart Association's classification of the segmentation of the left ventricular myocardium. Additionally, intraluminal diseases and abnormalities in the main coronary arteries and branches were investigated. Following segment-by-segment analysis, perfusion deficiencies identified on the iodine map pictures on DECT were identified.
The study enrolled a total of 87 patients. Forty-two of these individuals were classified as COVID-19 positive, and 45 were classified as controls. Perfusion deficits were identified in 66.6% ( = 30) of the cases. All control patients had a normal iodine distribution map. Perfusion deficits were found on DECT iodine map images with subepicardial ( = 12, 40%), intramyocardial ( = 8, 26.6%), or transmural ( = 10, 33.3%) anatomical locations within the left ventricular wall. There was no subendocardial involvement in any of the patients.
Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion. These deficits can be shown DECT with a perfect interrater agreement. Additionally, the presence of perfusion deficit is positively correlated with D-dimer levels.
文献中尚未发现有关双能计算机断层扫描（DECT）评估2019冠状病毒病（COVID-19）患者可能致命的心脏/心肌问题的研究。即使没有任何明显的冠状动脉闭塞，COVID-19患者也可出现心肌灌注不足，并且这些不足可通过DECT显示，阅片者间一致性良好。
评估COVID-19患者的肺灌注改变。据我们所知，尚未有研究使用DECT来评估COVID-19患者可能致命的心脏/心肌问题。本研究的目的是评估DECT在检测COVID-19相关心脏疾病中的作用。
两名盲法独立检查者根据美国心脏协会左心室心肌分段分类的17段模型评估CT图像。此外，还研究了主要冠状动脉及其分支的管腔内疾病和异常情况。在逐段分析后，确定DECT碘图上发现的灌注不足。
本研究共纳入87例患者。其中42例被分类为COVID-19阳性，45例为对照组。66.6%（n = 30）的病例发现有灌注不足。所有对照患者的碘分布图均正常。在DECT碘图图像上发现灌注不足位于左心室壁的心外膜下（n = 12，40%）、心肌内（n = 8，26.6%）或透壁（n = 10，33.3%）解剖位置。所有患者均无心内膜下受累。
即使没有任何明显的冠状动脉闭塞，COVID-19患者也可出现心肌灌注不足。这些不足可通过DECT显示，阅片者间一致性良好。此外，灌注不足的存在与D-二聚体水平呈正相关。
