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Fig. 1F —63-year-old man with chronically occluded coronary stent over
left anterior descending artery and infarcted myocardium. This case shows
importance of comprehensive evaluation of cardiac CT. Horizontal long-axis
image during delayed phase shows thrombus (white arrow) in left
ventricular apex. In arterial phase, it is sometimes difficult to
differentiate between left ventricular myocardium and firmly attached mural
thrombus. But in delayed phase, because of different contrast medium washout
pattern, thrombus (white arrow) is easily differentiated from normal
viable myocardium (black arrow). Due to lack of blood supply, the
thrombus (white arrow) would present like the `microvascular
obstruction' myocardium (arrowhead), as delayed perfusion defect. But
the thrombus would protrude into the left ventricular cavity, and the delayed
defect is located within the myocardium.
