CT POSSIBILITIES IN THE DIAGNOSTICS OF THE HEART SHRAPNEL WOUNDS
Akhiev M.I.1,2, Kitaev V.M.1,3, Abnizov A.S.1
1 – National Medical Research Center of High Medical Technologies, A.A. Vishnevsky Central Military Clinical Hospital, the Russian Ministry of Defense. Krasnogorsk, Russia.
2 – S.M. Kirov Military Medical Academy, the Russian Ministry of Defense. Moscow, Russia.
3 – Central State Medical Academy, the Presidential Executive Office of the Russian Federation. Department of Radiology and Ultrasound Diagnostics. Moscow, Russia.
|
P |
urpose. To study the relationship between the CT appearance of artifacts of cardiac wounds and the magnitude of fragment displacement during pulsation. Based on this, we developed a tomogram analysis method for recognizing the type of wound and the likelihood of fragment displacement.
Materials and Methods. CT scans of 78 wounded patients were retrospectively analyzed. The sample included cases of cardiac wounds with fragments ranging in size from 1-4 mm and a nearly spherical shape. Particular attention was paid to the images of artifacts from metal fragments, and, during repeat CT examinations, to possible changes in their appearance. The image reconstruction thickness was 1.5 mm.
Results and Discussion. A retrospective analysis of CT images of 78 cases of cardiac wounds revealed a relationship between the appearance of artifacts and the magnitude of fragment displacement, enabling the differentiation of fragments into fixed and mobile fragments during the initial examination. Mobile fragments were located in the pericardial cavity, producing type 4 artifacts and migrating within the pericardial cavity. Deep wounds produced type 3 artifacts. In deep wounds, the fragment penetrated the ventricular myocardium or deeper, into the layer of fleshy trabeculae and further into the cardiac cavities. Upon entering the ventricular cavities, fragments were fixed in the fleshy trabeculae, and among all penetrating wounds, no cases of fragment migration were recorded.
Conclusion. When deciding to remove displaced and potentially displaced fragments, a control CT scan is necessary before surgery. Penetrating cardiac wounds are identified using contrast-enhanced CT. Small fragments in penetrating wounds are fixed in the layer of fleshy trabeculae of the endocardium; the likelihood of their migration is low.
Keywords: CT diagnostics of cardiac wounds, artifacts from shrapnel in the heart, displacement of shrapnel in the heart, diagnostics of penetrating and non-penetrating cardiac wounds.
Corresponding author: Akhiev M.I., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Akhiev M.I., Kitaev V.M., Abnizov A.S. CT possibilities in the diagnostics of the heart shrapnel wounds. REJR 2025; 15(4):85-99. DOI: 10.21569/2222-7415-2025-15-4-85-99.
Received: 09.11.25 Accepted: 04.12.25