心肌结核的多模式成像,呈现为右心室心肌病:一个病例报告
Manphool Singhal1, Maninder Kaur1, Harmandeep Singh2
1Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Asian cardiovascular & thoracic annals
|July 13, 2023
概括
结核病可以影响年轻人的心脏和大脑,呈现为心力衰竭和神经病变. 早期诊断和抗结核治疗导致了显著的临床和成像改善.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 传染性疾病 传染性疾病
背景情况:
- 在一个18岁的男性中,右侧心力衰竭促使了调查.
- 最初的发现包括红细胞沉积率升高和双心室功能障碍.
研究的目的:
- 调查年轻男性心力衰竭和神经病变的原因.
- 评估疑似传播性结核病的抗结核治疗的疗效.
主要方法:
- 使用过胸腔心声学 (TTE),氧葡萄糖-正子辐射断层扫描,计算机断层扫描 (FDG-PET-CT),心脏磁共振成像 (CMR) 和脑MRI.
- 进行了内肌心活检以进行组织病理学检查.
- 根据临床和成像发现,启动了标准抗结核治疗.
主要成果:
- FDG-PET-CT揭示了加厚的右心室 (RV) 壁的吸收增加和FDG-狂热的脑损伤.
- 脑磁共振扫描显示RV变厚,暗示透性疾病;脑磁共振扫描发现了一个环增强性病变.
- 心脏内膜活检证实了淋巴细胞核炎症与颗粒瘤的形成.
- 治疗导致临床改善,增强了双心脏功能,减少了RV加厚,并解决了大脑病变.
结论:
- 传播性结核病被证实是心脏和神经症状的原因.
- 及时诊断和抗结核疗法在治疗心脏和神经结核病方面是有效的.
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