Schoenhagen Paul, Stillman Arthur E, Halliburton Sandy S, Kuzmiak Stacie A, Painter Tracy, White Richard D
Department of Radiology, Center for Integrated Non-Invasive Cardiovascular Imaging, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Int J Cardiovasc Imaging. 2005 Feb;21(1):63-72. doi: 10.1007/s10554-004-1887-y.
Selective coronary angiography introduced clinical coronary imaging in the late 1950s. The angiographic identification of high-grade coronary lesions in patients with acute and chronic symptomatic coronary artery disease (CAD) led to the development of surgical and percutaneous coronary revascularization. However, the fact that CAD remains the major cause of death in North America and Europe demonstrates the need for novel, complementary diagnostic strategies. These are driven by the need to characterize both increasingly advanced disease stages but also early, asymptomatic disease development. Complex revascularization techniques for patients with advanced disease stages will initiate a growing demand for 3-dimensional coronary imaging and integration of imaging modalities with new mechanical therapeutic devices. An emerging focus is atherosclerosis imaging with the goal to identify subclinical disease stages as the basis for pharmacological intervention aimed at disease stabilization or reversal. Non-invasive coronary imaging with coronary multidetector computed tomographic angiography (MDCTA) allows both assessment of luminal stenosis and subclinical disease of the arterial wall. Its complementary role in the assessment of early and advanced stages of CAD is increasingly recognized.
选择性冠状动脉造影在20世纪50年代末引入了临床冠状动脉成像。对急性和慢性症状性冠状动脉疾病（CAD）患者进行血管造影识别高级别冠状动脉病变，促使了外科和经皮冠状动脉血运重建术的发展。然而，CAD仍然是北美和欧洲主要死因这一事实表明，需要新的补充性诊断策略。这是由既要表征日益进展的疾病阶段，也要表征早期无症状疾病发展的需求所驱动的。针对疾病进展阶段患者的复杂血运重建技术，将引发对三维冠状动脉成像以及成像模态与新型机械治疗设备整合的需求不断增加。一个新出现的重点是动脉粥样硬化成像，目标是识别亚临床疾病阶段，作为旨在稳定或逆转疾病的药物干预的基础。采用冠状动脉多排螺旋CT血管造影（MDCTA）的非侵入性冠状动脉成像，既可以评估管腔狭窄，也可以评估动脉壁的亚临床疾病。其在CAD早期和进展期评估中的补充作用日益得到认可。
