Beller George A
Cardiovascular Division, University of Virginia Health System, Charlottesville, Virginia 22908-0158, USA.
J Am Coll Cardiol. 2006 Oct 3;48(7):1299-303. doi: 10.1016/j.jacc.2006.04.096. Epub 2006 Sep 14.
Cardiovascular (CV) imaging has experienced major growth and technological advances with respect to the long-standing traditional cardiac imaging procedures of echocardiography and nuclear cardiology, the emergence of cardiac computed tomography and magnetic resonance imaging in clinical practice, and multimodality and molecular imaging as new technologies. Therefore, it is perhaps timely to change the training paradigm for fellows interested in emphasizing CV imaging as a subspecialty in their professional careers and desiring extensive training in all CV imaging modalities. Proposed is the establishment of a formal fourth year of training leading to board certification in advanced CV imaging. Areas of training would include the acquisition of knowledge of physics and instrumentation related to the various imaging modalities, interpretation and quantitation of imaging variables, multimodality imaging technology, molecular and vascular imaging, and clinical guidelines with appropriateness criteria for all technologies. The training track would lead to an American Board of Internal Medicine examination for a Certificate of Added Qualification, similar to that for subspecialization in electrophysiology and interventional cardiology, with noninvasive cardiologists who have already completed fellowship training given the opportunity to sit for an examination on the basis of predetermined eligibility criteria. One benefit of this CV imaging subspecialty track that provides cardiologists with expertise in all imaging modalities is the capability to select the best modality for the clinical indication and to independently interpret multimodality imaging studies. Its rigorous didactic and procedural requirements would enhance quality of CV imaging, enhance research, and increase the speed with which new discoveries are translated into practice. This ultimately would yield better patient outcomes.
心血管（CV）成像领域经历了重大发展和技术进步，这体现在长期存在的传统心脏成像技术（如超声心动图和核心脏病学）、心脏计算机断层扫描和磁共振成像在临床实践中的出现，以及多模态和分子成像等新技术方面。因此，对于那些希望在职业生涯中将CV成像作为亚专业重点并渴望接受所有CV成像模态广泛培训的学员来说，或许是时候改变培训模式了。提议设立正式的第四年培训，以获得高级CV成像的委员会认证。培训领域将包括获取与各种成像模态相关的物理和仪器知识、成像变量的解释和定量、多模态成像技术、分子和血管成像，以及所有技术的临床指南和适用性标准。该培训路径将通向美国内科医学委员会的额外资格证书考试，类似于电生理学和介入心脏病学亚专业的考试，已完成 fellowship 培训的非侵入性心脏病专家将有机会根据预定的资格标准参加考试。这种为心脏病专家提供所有成像模态专业知识的CV成像亚专业路径的一个好处是，有能力为临床指征选择最佳模态并独立解释多模态成像研究。其严格的教学和程序要求将提高CV成像质量、加强研究，并加快新发现转化为实践的速度。这最终将带来更好的患者预后。
