Weigold Wm Guy
Division of Cardiovascular Disease, Washington Hospital Center, Washington, DC 20010, USA.
Tech Vasc Interv Radiol. 2006 Dec;9(4):205-9. doi: 10.1053/j.tvir.2007.03.005.
Cardiac computed tomography (CT) and coronary CT angiography represent a breakthrough in cardiac diagnostic power and are already making an impact on clinical practice. Yet, technical limitations remain and patients must be appropriately selected for this new and exciting examination. An understanding of those limitations will help guide patient selection and maximize the clinical yield of the test. The most significant issues to deal with are those of inherently increased image noise, vulnerability to cardiac and respiratory motion and arrhythmia, and image artifacts that result from the presence of coronary calcification and stents. Fortunately, there are methods to overcome all of these limitations. These predominantly involve diligent and attentive patient preparation before the scan, focusing on clinical, hemodynamic, and basic eletrocardiographic parameters. With proper premedication to optimize heart rate, simple patient coaching, attention to detail during the acquisition, and the use of software tools to optimize the axial image reconstruction, cardiac CT should consistently yield very satisfying results.
心脏计算机断层扫描（CT）和冠状动脉CT血管造影代表了心脏诊断能力的一项突破，并且已经对临床实践产生影响。然而，技术限制仍然存在，必须对患者进行适当选择才能进行这项新颖且令人兴奋的检查。了解这些限制将有助于指导患者选择，并使检查的临床收益最大化。需要处理的最重大问题是图像噪声固有增加、易受心脏和呼吸运动及心律失常影响，以及由冠状动脉钙化和支架的存在导致的图像伪影。幸运的是，有方法可以克服所有这些限制。这些方法主要包括在扫描前对患者进行认真细致的准备，重点关注临床、血流动力学和基本心电图参数。通过适当的预处理来优化心率、对患者进行简单指导、在采集过程中注重细节以及使用软件工具来优化轴向图像重建，心脏CT应该能够始终产生非常令人满意的结果。
