| 2 | 心脏CT对新近心肌梗死和慢性心肌梗死的鉴别诊断显示文摘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(< 7 days, n=16), long-standing 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, p< 0.001). The attenuation difference between infarcted and remote myocardia was larger in patients with long-standing MI than in patients with recent MI(89±41 and 55±33 HU, respectively, p< 0.001). In addition, long-standing MI was associated with wall thinning(p< 0.01), and ventricular dilation(p< 0.05), whereas recent MI was not(p >0.05). In conclusion, recent and long-standing MIs may be differentiated by computed tomography based on myocardial CT attenuation values and ventricular dimensions. | Nieman K. Cury R.C. Ferencik M. 杜媛 | 2006 | 世界核心医学期刊文摘(心脏病学分册)2006，，12： | 0 |
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