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Troponin-Positive Non-Obstructive Coronary Arteries and Myocardial Infarction with Non-Obstructive Coronary Arteries: Definition, Etiologies, and Role of CT and MR Imaging

Korean Journal of Radiology 2020년 21권 12호 p.1305 ~ 1316
유승민, 장소원, 김정아, 전은주,
소속 상세정보
유승민 ( Yoo Seung-Min ) - CHA University CHA Bundang Medical Center Department of Radiology
장소원 ( Jang So-Won ) - Seoul National University Bundang Hospital Department of Radiology
김정아 ( Kim Jeong-Ah ) - Yonsei University Yongin Severance Hospital Department of Radiology
전은주 ( Chun Eun-Ju ) - Seoul National University Bundang Hospital Department of Radiology

Abstract


In approximately 10% of patients with acute myocardial infarction (MI), angiography does not reveal an obstructive coronary stenosis. This is known as myocardial infarction with non-obstructive coronary arteries (MINOCA), which has complex and multifactorial causes. However, this term can be confusing and open to dual interpretation, because MINOCA is also used to describe patients with acute myocardial injury caused by ischemia-related myocardial necrosis. Therefore, with regards to this specific context of MINOCA, the generic term for MINOCA should be replaced with troponin-positive with non-obstructive coronary arteries (TpNOCA). The causes of TpNOCA can be subcategorized into epicardial coronary (causes of MINOCA), myocardial, and extracardiac disorders. Cardiac magnetic resonance imaging can confirm MI and differentiate various myocardial causes, while cardiac computed tomography is useful to diagnose the extracardiac causes.

키워드

Troponin; CT; MR; Acute myocardial infarction

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