Schussler Jeffrey M, Grayburn Paul A
Department of Internal Medicine, Division of Cardiology, Baylor University Medical Center/Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Texas, USA.
Heart. 2007 Mar;93(3):290-7. doi: 10.1136/hrt.2005.069195. Epub 2005 Dec 30.
Non-invasive methods for detection of coronary atherosclerosis have been limited to indirect markers, such as myocardial perfusion or wall motion during exercise or pharmacological stress. However, advances in multislice computed tomography (MSCT) not allow sufficient spatial resolution for direct non-invasive imaging of the coronary arteries. This review focuses on imaging techniques and clinical applications of MSCT in human studies. Published studies of the diagnostic accuracy of MSCT in native coronary arteries and bypass grafts indicate excellent sensitivity and specificity for detection of 50% diameter stenosis. MSCT is particularly good for evaluating the origin and course of anomalous coronary arteries. MSCT offers the ability to visualise both the lumen and wall of artery, as well as to quantify coronary classification. Further technical developments promise to render MSCT the ideal non-invasive tool for direct visualisation of the coronary arteries.
用于检测冠状动脉粥样硬化的非侵入性方法一直局限于间接标志物,如运动或药物负荷期间的心肌灌注或壁运动。然而,多层计算机断层扫描(MSCT)的进展并不足以提供足够的空间分辨率用于冠状动脉的直接非侵入性成像。本综述重点关注MSCT在人体研究中的成像技术和临床应用。已发表的关于MSCT在天然冠状动脉和搭桥血管诊断准确性的研究表明,对于检测50%直径狭窄具有出色的敏感性和特异性。MSCT在评估异常冠状动脉的起源和走行方面特别有用。MSCT能够可视化动脉的管腔和壁,还能对冠状动脉进行分类量化。进一步的技术发展有望使MSCT成为直接可视化冠状动脉的理想非侵入性工具。