Hoffmann Udo, Ferencik Maros, Cury Ricardo C, Pena Antonio J
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
J Nucl Med. 2006 May;47(5):797-806.
Advances in multidetector CT (MDCT) technology with submillimeter slice collimation and high temporal resolution permit contrast-enhanced imaging of coronary arteries and coronary plaque during a single breath hold. Appropriate patient preparation, detailed technical and technological knowledge with regard to recognition of typical imaging artifacts (such as beam hardening or motion artifacts), and the adequate choice of postprocessing techniques to detect stenosis and plaque are prerequisites to achieving diagnostic image quality. A growing number of studies have suggested that 64-slice coronary CT angiography is highly accurate for the exclusion of significant coronary artery stenosis (>50% luminal narrowing), with negative predictive values of 97%-100%, in comparison with invasive selective coronary angiography. In addition, several studies have indicated that MDCT also can detect calcified and noncalcified coronary atherosclerotic plaques, especially in proximal vessel segments, showing a good correlation with intracoronary ultrasound. Studies on clinical utility, cost, and cost-effectiveness are now warranted to demonstrate whether and how this technique can change and improve the current management of patients with suspected or confirmed coronary artery disease.
具有亚毫米层厚准直和高时间分辨率的多排螺旋CT（MDCT）技术进展，使得在单次屏气期间能够对冠状动脉和冠状动脉斑块进行对比增强成像。适当的患者准备、关于识别典型成像伪影（如线束硬化或运动伪影）的详细技术知识，以及选择用于检测狭窄和斑块的适当后处理技术，是获得诊断图像质量的先决条件。越来越多的研究表明，与有创选择性冠状动脉造影相比，64层冠状动脉CT血管造影在排除显著冠状动脉狭窄（管腔狭窄>50%）方面具有高度准确性，阴性预测值为97%-100%。此外，多项研究表明，MDCT还能够检测钙化和非钙化冠状动脉粥样硬化斑块，尤其是在近端血管节段，与冠状动脉内超声显示出良好的相关性。现在有必要进行关于临床效用、成本和成本效益的研究，以证明该技术是否以及如何能够改变和改善目前对疑似或确诊冠状动脉疾病患者的管理。
