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Epipericardial Fat Necrosis in a Pediatric Patient Diagnosed Using Contrast-Enhanced MRI Findings: A Case Report and Literature Review

소아 심장막 주위 지방 괴사 환자에서의 조영증강 자기공명영상 소견: 증례 보고 및 문헌고찰

  • Seong Ju Kim (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Byoung Hee Han (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Youngjong Cho (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Dae Shick Ryu (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Ga Young Yoon (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Wooyul Paik (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Young Rae Kim (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine)
  • 김승주 (울산대학교 의과대학 강릉아산병원 영상의학과) ;
  • 한병희 (울산대학교 의과대학 강릉아산병원 영상의학과) ;
  • 조영종 (울산대학교 의과대학 강릉아산병원 영상의학과) ;
  • 류대식 (울산대학교 의과대학 강릉아산병원 영상의학과) ;
  • 윤가영 (울산대학교 의과대학 강릉아산병원 영상의학과) ;
  • 백우열 (울산대학교 의과대학 강릉아산병원 영상의학과) ;
  • 김영래 (울산대학교 의과대학 강릉아산병원 영상의학과)
  • Received : 2021.09.24
  • Accepted : 2021.12.28
  • Published : 2022.09.01

Abstract

Epipericardial fat necrosis (EPFN) is a relatively rare cause of acute chest pain, with only five pediatric cases having been reported in the English-language medical literature to date. EPFN can be diagnosed based on the clinical symptoms of acute pleuritic chest pain and classic CT features of typically ovoid fatty lesions surrounded by a rim or capsule in the mediastinal or pericardial areas. Previous studies have reported that contrast-enhanced MRI can detect typical fat signal changes in adults with EPFN. We report a pediatric EPFN case diagnosed using gadolinium-enhanced MRI. Thus, contrast-enhanced MRI may be used to confirm EPFN in the differential diagnoses of the causes of acute chest pain.

심장막 주위 지방 괴사는 급성흉통의 비교적 드문 원인으로서 현재까지 영문으로 보고된 소아 증례는 5건에 불과하다. 심장막 주위 지방 괴사는 급성 흉막통증의 임상증상과 종격동이나 심장막 부위에 타원형의 피막으로 둘러싸인 지방 병소로 나타나는 전형적인 전산화단층촬영 소견으로 진단할 수 있다. 성인의 경우 조영증강 자기공명영상 검사가 전형적인 지방신호 변화를 확인할 수 있어 유용하다는 보고가 있다. 본 논문에서는 저자들은 소아 심장막 주위 지방 괴사 환자의 증례를 통해 조영증강 자기공명영상 소견에 대해 기술하고 급성흉통의 감별진단에 있어 유용성을 보고한다.

Keywords

References

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