Fujita Miyuko, Kitagawa Kakuya, Domae Kensuke, Yamaguchi Shintaro, Kokawa Takanori, Takafuji Masafumi, Ichikawa Yasutaka, Sakuma Hajime
Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie Prefecture 514-8507, Japan.
Radiol Case Rep. 2024 Feb 13;19(5):1708-1711. doi: 10.1016/j.radcr.2024.01.083. eCollection 2024 May.
Epipericardial fat necrosis (EFN) is a rare benign cause of chest pain, that is frequently overlooked. EFN involves the necrosis of fat tissue in the mediastinum, and presents on computed tomography (CT) as an ovoid lesion of fat attenuation surrounded by a rim of soft tissue attenuation. This case report describes a case of a 50-year-old man diagnosed with EFN on cardiac CT, which was incidentally associated with apical hypertrophic myocardiopathy. Notably, the detection of EFN proved difficult on arterial phase images during coronary CT angiography, whereas it was much easier to detect on delayed phase images. EFN should be considered in the differential diagnosis of chest pain, and careful examination of mediastinal fat is crucial for accurate diagnosis.
心包外脂肪坏死（EFN）是一种罕见的胸痛良性病因，常被忽视。EFN累及纵隔脂肪组织坏死，在计算机断层扫描（CT）上表现为脂肪密度的椭圆形病灶，周围有软组织密度环。本病例报告描述了一名50岁男性，其心脏CT诊断为EFN，偶然与肥厚型心肌病相关。值得注意的是，在冠状动脉CT血管造影的动脉期图像上很难检测到EFN，而在延迟期图像上则更容易检测到。在胸痛的鉴别诊断中应考虑EFN，仔细检查纵隔脂肪对准确诊断至关重要。
