Incidental Myocardial Infarct on Conventional Nongated CT: A Review of the Spectrum of Findings With Gated CT and Cardiac MRI Correlation

AJR :198, March 2012

Jabi E. Shriki Jerold Shinbane Christopher Lee Abdur R. Khan Natalie Burns Antereas Hindoyan Alison Wilcox

OBJECTIVE. Myocardial infarctions (MIs) are frequently evident on routine chest or ab­dominal CT, even when studies are not performed for cardiac-specific indications. However, the telltale signs of an MI may be easily overlooked. Herein, we present the spectrum of ap­pearances of MIs, including areas of fat attenuation, myocardial calcifications, focal areas of wall thinning or aneurysm formation, and perfusion abnormalities. Thrombi, especially when present at the apex of the left ventricle, may also suggest an MI.

CONCLUSION. The increased use of CT in the evaluation of patients for a variety of indications gives the radiologist the unique opportunity to recognize findings consistent with MI in patients who may not have a prior diagnosis of ischemic heart disease.