心脏CT对新近心肌梗死和慢性心肌梗死的鉴别诊断

作     者：Nieman K. Cury R.C. Ferencik M. 杜媛 

作者机构：Department of RadiologyMassachusetts General Hospital BostonMA United States Dr. 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2006年第2卷第12期

页      面：13-14页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：心肌梗死 CT 正常心肌 心脏 

摘      要：Clinical use of cardiac computed tomography is rapidly expanding, and its purpose may reach beyond noninvasive coronary angiography. We investigated the ability of 64-slice multidetector computed tomography to differentiate between recent and long-standing myocardial infarction(MI). Contrast-enhanced coronary computed tomographic(CT) scans(Siemens Sensation 64) of patients with a recent MI(12 months,n=13), and no MI(n=13)were retrospectively evaluated. To anticipate transmural variation of myocardial perfusion and to neutralize image noise, a series of thin, overlapping slices was created in parallel alignment to the myocardial wall. Within each of these slices, a small region of interest was placed at a constant in-plane position to measure the CT attenuation(Hounsfield units[HU]) at consecutive transmural locations of injured and normal remote myocardium. In addition, wall thickness and the myocardial cavity were measured. Significantly lower CT attenuation values were found in patients with long-standing MI(-13±37 HU) than in those with acute MI(26±26 HU) and normal controls(73±14 HU, p0.05). In conclusion, recent and long-standing MIs may be differentiated by computed tomography based on myocardial CT attenuation values and ventricular dimensions.