Ohnesorge Bernd M, Hofmann Lars K, Flohr Thomas G, Schoepf U Joseph
Division CT, Siemens Medical Solutions, Medical University of South Carolina, Charleston, SC 29425, USA.
Int J Cardiovasc Imaging. 2005 Feb;21(1):85-104. doi: 10.1007/s10554-004-5346-6.
Current generation multidetector-row CT (MDCT) enables high-resolution, motion-free imaging of the heart within a single, short breath-hold. MDCT allows highly accurate and reproducible quantification of coronary artery calcium, a marker that has been used for the detection, exclusion and monitoring of coronary atherosclerosis. The exact role of coronary calcium measurements for cardiac risk stratification remains unclear to date. At contrast enhanced MDCT coronary angiography coronary arteries can be visualized with unprecedented detail. The accurate non-invasive assessment of the presence and degree of coronary artery stenosis appears within reach. With increasing accuracy MDCT enables non-invasive patency evaluation of coronary artery bypass grafts and coronary stents. The cross-sectional nature of contrast enhanced MDCT coronary angiography allows assessment of the vessel wall and may permit more accurate quantification of total atherosclerotic plaque burden than measuring calcified components alone. For a limited time, future technical improvement will be pursued mainly by accelerated gantry rotation speed and additional detector rows. However, novel concepts of CT image acquisition are already under investigation and may bring about yet another quantum leap for medical CT. This communication discusses potential approaches for the beneficial utilization of MDCT for the assessment of patients with known or suspected coronary heart disease.
当代多层螺旋CT（MDCT）能够在单次短暂屏气期间对心脏进行高分辨率、无运动干扰的成像。MDCT可对冠状动脉钙化进行高度准确且可重复的定量分析，冠状动脉钙化是一种用于检测、排除和监测冠状动脉粥样硬化的标志物。冠状动脉钙化测量在心脏风险分层的确切作用至今仍不明确。在对比增强MDCT冠状动脉造影中，冠状动脉能够以前所未有的细节显示出来。冠状动脉狭窄的存在和程度的准确无创评估似乎指日可待。随着准确性的提高，MDCT能够对冠状动脉搭桥移植术和冠状动脉支架进行无创通畅性评估。对比增强MDCT冠状动脉造影的横断面特性允许对血管壁进行评估，并且与仅测量钙化成分相比，可能能够更准确地定量总动脉粥样硬化斑块负荷。在有限的时间内，未来的技术改进将主要通过加快机架旋转速度和增加探测器排数来实现。然而，CT图像采集的新概念已经在研究中，可能会给医学CT带来又一次巨大飞跃。本文讨论了将MDCT有益地用于评估已知或疑似冠心病患者的潜在方法。
