Basal septal perforator vein mimicking the “late iodine enhancement” in delayed phase cardiac CT for myocardial scar assessment

Masafumi Kidoh, MD; Seitaro Oda, MD; Daisuke Utsunomiya, MD; Takafumi Emoto, RT; Takeshi Nakaura, MD; Yasunori Nagayama, MD; Masahiro Yamamoto, MD; Kenji Sakamoto, MD; Eiichiro Yamamoto, MD; Koichi Kaikita, MD; Kenichi Tsujita, MD; Yasuyuki Yamashita, MD

Radiology Case Reports (May 2019)

Basal septal perforator vein mimicking the “late iodine enhancement” in delayed phase cardiac CT for myocardial scar assessment

Masafumi Kidoh, MD,
Seitaro Oda, MD,
Daisuke Utsunomiya, MD,
Takafumi Emoto, RT,
Takeshi Nakaura, MD,
Yasunori Nagayama, MD,
Masahiro Yamamoto, MD,
Kenji Sakamoto, MD,
Eiichiro Yamamoto, MD,
Koichi Kaikita, MD,
Kenichi Tsujita, MD,
Yasuyuki Yamashita, MD

Affiliations

Masafumi Kidoh, MD: Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan; Corresponding author.
Seitaro Oda, MD: Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
Daisuke Utsunomiya, MD: Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
Takafumi Emoto, RT: Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
Takeshi Nakaura, MD: Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
Yasunori Nagayama, MD: Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan
Masahiro Yamamoto, MD: Department of Cardiology, Oguni Municipal Hospital, Oguni-Machi, Aso-Gun, Kumamoto, Japan
Kenji Sakamoto, MD: Department of Cardiology, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
Eiichiro Yamamoto, MD: Department of Cardiology, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
Koichi Kaikita, MD: Department of Cardiology, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
Kenichi Tsujita, MD: Department of Cardiology, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
Yasuyuki Yamashita, MD: Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Chuo-ku, Kumamoto 860-8556, Japan

Journal volume & issue: Vol. 14, no. 5
pp. 588 – 590

Abstract

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Delayed-phase cardiac CT is a useful tool for scar detection, based on differences in the volume of distribution of iodine. Although it covers the entire heart, provides uniform, high isotropic spatial resolution, and therefore may be useful for detecting small late iodine enhancement (LIE), we need to correctly differentiate small LIE and pseudo-lesions mimicking LIE. In this case report, we demonstrate basal septal perforator vein mimicking LIE in delayed phase cardiac CT. Left ventricular myocardium includes not only septal vein and artery but also capillaries, arterio- and venoluminal vessels, and sinusoids, etc. which connect to septal veins. To avoid misinterpretations of myocardial LIE on the delayed phase images, we need to understand those anatomical features. Keywords: Delayed iodine CT, Late iodine enhancement, Myocardial infarction, Myocardial scar, Septal perforator vein

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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