Lipomatous hypertrophy of the interatrial septum - A prospective study of incidence, imaging findings, and clinical symptoms
Lipomatous hypertrophy of the interatrial septum - A prospective study of incidence, imaging findings, and clinical symptoms
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DOI：
10.1378/chest.124.6.2068
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发表时间：
2003-12-01
期刊：
影响因子：
9.6
通讯作者：
Nicolas, V
中科院分区：
文献类型：
--
作者：
Heyer, CM;Kagel, T;Nicolas, V
背景：房间隔脂肪瘤性肥大（LHIS）是一种以房间隔脂肪堆积为特征的良性疾病。它通常发生在老年人，肥胖的患者，并可能导致心律失常。目的：本研究的目的是确定这种心脏病理使用多层螺旋CT（MSCT）的影像学特征，其与临床表现的关系。材料与方法：前瞻性研究了2001年9月至2002年8月期间接受胸部MSCT检查的1,292例连续患者。除了分析病人的记录，在心房的脂肪量。结果：在1,292例患者中，发现LHIS 28例（2.2%）。受影响患者的平均年龄为72.2岁。多层螺旋CT检查显示大量的脂肪密度减低，边缘锐利，卵圆窝保留，所有患者均呈哑铃形。房间隔厚度中位数为32 mm（范围，20 ~ 62 mm），头尾延伸中位数为62 mm（范围，51 ~ 89 mm）。21例患者（75.0%）表现为心外膜脂肪增加，18例患者（64.3%）有明显的肺气肿，21例患者中有13例（61.9%）表现为ECG异常。3例患者接受了功能性心脏MRI研究。在一个病人，血流动力学阻塞LHIS showed.Conclusions：多层螺旋CT扫描是一个有用的方法来诊断LHIS，心脏疾病，在我们的系列达到2.2%的发病率。病变显示特征性特征，从而与其他心脏肿瘤相区别。高龄、肥胖、肺气肿和房性心律失常是LHIS患者常见的其他表现。
Background: Lipomatous hypertrophy of the interatrial septum (LHIS) is a benign disorder characterized by fat accumulation in the interatrial septum. It typically occurs in elderly, obese patients and may cause arrhythmia.Objectives: The purpose of this study was to determine the imaging features of this cardiac pathology using multislice CT (MSCT), and its relationship with clinical findings. Materials and methods: A total of 1,292 consecutive patients who underwent MSCT of the thorax from September 2001 to August 2002 were prospectively studied. Beside the analysis of patient records, the amount of fat in the interatrial. septum, and its size and shape were determined.Results: Among the 1,292 patients investigated, we found 28 (2.2%) with LHIS. The mean age of affected patients was 72.2 years. MSCT studies revealed a mass of fat attenuation with sharp margins and sparing of the fossa ovalis, resulting in a dumbbell shape in all patients. The median thickness of the interatrial septum was 32 mm (range, 20 to 62 mm), and the median craniocaudal extend was 62 nun (range, 51 to 89 mm). Twenty-one patients (75.0%) showed increased epicardial fat, 18 patients (64.3%) had significant pulmonary emphysema, and 13 of 21 patients (61.9%) showed ECG abnormalities. Three patients underwent functional cardiac MRI studies. In one patient, hemodynamic obstruction by LHIS was shown.Conclusions: MSCT scanning is a useful method to diagnose LHIS, a cardiac condition that in our series reached a 2.2% incidence. The lesion shows characteristic features, thus differentiating it from other cardiac tumors. Advanced age, obesity, pulmonary emphysema, and atrial arrhythmias are common additional findings in patients with LHIS.