Masuda Y, Yoshida H, Morooka N, Watanabe S, Inagaki Y
Circulation. 1984 Aug;70(2):217-25. doi: 10.1161/01.cir.70.2.217.
Conventional and enhanced computed tomographic (CT) examinations were performed in 103 patients with myocardial infarction for evaluation of the diagnostic usefulness of CT. After intravenous bolus injection of contrast material, an initial filling defect and late enhancement of the infarcted myocardium appeared on the cardiac CT images. These two findings were direct evidence of myocardial infarction; the former was found mostly in the patient with recent myocardial infarctions, and the latter was recognized both in those with recent and those with "remote" infarctions. Wall thinning at the site of infarction was found by enhanced CT mostly in patients with anteroseptal or extensive anterior infarctions, and was rarely found in patients with inferoposterior infarctions. Left ventricular aneurysms and ventricular thrombi were found by enhanced CT in 39 and 23 of the 103 subjects, respectively, and the sensitivity of CT in detecting intracardiac thrombi was higher than that of two-dimensional echocardiography. Calcification of the myocardium and pericardial effusion associated with myocardial infarction were also detected by conventional nonenhanced CT. Thus, cardiac CT was found to be a useful test in evaluating patients with myocardial infarction.
对103例心肌梗死患者进行了常规和增强计算机断层扫描（CT）检查，以评估CT的诊断价值。静脉推注造影剂后，心脏CT图像上出现梗死心肌的初始充盈缺损和延迟强化。这两个发现是心肌梗死的直接证据；前者多见于近期心肌梗死患者，后者在近期和“陈旧性”梗死患者中均有发现。增强CT发现梗死部位的室壁变薄多见于前间隔或广泛前壁梗死患者，下后壁梗死患者很少见。增强CT在103例受试者中分别发现39例左心室室壁瘤和23例心室血栓，CT检测心内血栓的敏感性高于二维超声心动图。常规非增强CT也检测到与心肌梗死相关的心肌钙化和心包积液。因此，心脏CT被发现是评估心肌梗死患者的一项有用检查。
