【摘要】 目的:探讨心肌脂肪浸润的MSCT表现,研究生理性心肌脂肪浸润和病毒性心肌炎分布特征。材料与方法:回顾性分析294例诊断心肌脂肪浸润的患者,每例患者的CT扫描原始数据均行心脏多平面重建,分析生理性心肌脂肪浸润和病毒性心肌炎的MSCT影像表现。结果:294例生理性心肌脂肪浸润,脂肪密度区(平扫时CT值<-20Hu)。266例生理性脂肪浸润,按发生频数依次为:右室壁(77.82%,207/266)、右心室肌小梁(74.44%,198/266)、右心室节制索(42.10%,112/266)、左心室心尖部(12.03%,32/266)、室间隔右心室面(4.51%,12/266)、左心室乳头肌(1.88%,5/266)。累及右心室壁者平均厚度为3.7mm(2.0~10.5mm),平均年龄58.4岁,与年龄呈正相关关系(r=0.5770,P<0.05),无性别差异,厚度≤4mm者181例(68%,181/266),>4mm者85例(32%,85/266)。病毒性心肌炎28例,右室前壁22例(78.57%,22/28),肌小梁6例(21.43%,6/28),表现为斑点样、条状脂肪浸润。其脂肪分布各具一定特征性。结论:心脏脂肪浸润的形态特征和分布规律,有助于生理性和病毒性心肌炎的鉴别诊断。更多还原

【Abstract】 Purpose: To investigate imaging manifestations of physiologic fatty infiltration and viral myocarditis in the heart. Materials and Methods: The morphological characteristics and distribution patterns of fatty infiltration in the multi-planar reconstructive MSCT images of 294 patients,who were diagnosed as fatty infiltration in the heart,and analyzed the imaging manifestations of fatty infiltration. Results: 294 cases of fatty infiltration were correctly diagnosed by MSCT. 266 cases were physiologic fatty infiltration,myocardial fat as a focal area of lower attenuation( attenuation value below- 20Hu). The266 cases with physiologic fatty infiltration,the distribution patterns of which were as follow: the RV wall( 77. 82%,207 /266),RV trabeculae( 74. 44%,198 /266),RV moderator band( 42. 10%,112 /266),LV apex( 12. 03%,32 /266),RV side of the septum( 4. 51%,12 /266),and LV papillary muscle( 1. 88%,5 /266). The RV thickness of 266 cases with RV fatty infiltration was 2. 5 ~ 10. 5mm( average 3. 7mm) which was positively correlated with age( r = 0. 5770,P < 0. 05).All patients were asexuality difference. The RV thickness was less or equal 4mm in 181( 68%,181 /266) cases,and larger than 4mm in 85( 32%,85 /266) cases. 28 cases infected viral myocarditis( VM),the RV wall( 78. 57%,22 /28),RV trabeculae( 21. 43%,6 /28),CT images show linear and spots fat density in RV wall or( and) trabeculae. Conclusion: The morphological characteristics and distribution pattern of cardiac fat can help to differentiate the physiologic and viral myocarditis.更多还原