Gershlick A H, de Belder M, Chambers J, Hackett D, Keal R, Kelion A, Neubauer S, Pennell D J, Rothman M, Signy M, Wilde P
Department of Cardiology, University of Leicester, Glenfield Hospital, Leicester, UK.
Heart. 2007 Apr;93(4):423-31. doi: 10.1136/hrt.2006.108779.
Coronary angiography has been the gold standard for determining the severity, extent and prognosis of coronary atheromatous disease for the past 15-20 years. However, established non-invasive testing (such as myocardial perfusion scintigraphy and stress echocardiography) and newer imaging modalities (multi-detector x ray computed tomography and cardiovascular magnetic resonance) now need to be considered increasingly as a challenge to coronary angiography in contemporary practice. An important consideration is the degree to which appropriate use of such techniques impacts on the need for coronary angiography over the next 10-15 years. This review aims to determine the role of the various investigation techniques in the management of coronary artery disease and their resource implications, and should help determine future service provision, accepting that we are in a period of significant technological change.
在过去15到20年里,冠状动脉造影一直是确定冠状动脉粥样硬化疾病严重程度、范围和预后的金标准。然而,现有的非侵入性检测(如心肌灌注闪烁扫描和负荷超声心动图)以及更新的成像方式(多排螺旋计算机断层扫描和心血管磁共振成像)在当代实践中越来越被视为对冠状动脉造影的挑战。一个重要的考量是,在未来10到15年里,合理使用这些技术对冠状动脉造影需求的影响程度。本综述旨在确定各种检测技术在冠状动脉疾病管理中的作用及其资源影响,并应有助于确定未来的服务提供方式,同时承认我们正处于技术重大变革时期。