Auseon Alex J, Advani Sunil S, Bush Charles A, Raman Subha V
Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
Am J Med. 2009 Apr;122(4):387-91. doi: 10.1016/j.amjmed.2008.10.031.
The clinical role of cardiovascular multidetector computed tomography (CT) remains in evolution, and application varies widely. Understanding its impact on the utilization of other cardiovascular diagnostic modalities could help define best practices.
Utilization of diagnostic testing was examined for the initial 1053 consecutive patients who underwent cardiovascular multidetector CT examinations after scanner installation in 2005. Yearly procedural volumes in the invasive catheterization and noninvasive stress laboratories were assessed before and after the introduction of multidetector CT.
Ninety-one patients (8.6%) of the 1053 required invasive diagnostic catheterization; of these, nearly half subsequently underwent percutaneous or surgical intervention. Diagnostic catheterization and interventional volumes maintained their previous rates of annual increase, while the volume of stress testing decreased once multidetector CT became available.
The major impact of multidetector CT in initial cardiovascular practice is on the need and frequency of stress testing, with far less impact on utilization of cardiac catheterization and coronary interventions.
心血管多排螺旋计算机断层扫描（CT）的临床作用仍在不断演变，其应用差异很大。了解其对其他心血管诊断方式使用情况的影响有助于确定最佳实践方法。
对2005年扫描仪安装后连续接受心血管多排螺旋CT检查的前1053例患者的诊断测试使用情况进行了研究。在引入多排螺旋CT之前和之后，评估了有创导管插入术和无创应激实验室的年度手术量。
1053例患者中有91例（8.6%）需要进行有创诊断性导管插入术；其中，近一半患者随后接受了经皮或外科干预。诊断性导管插入术和介入手术量保持了之前的年增长率，而一旦多排螺旋CT可用，应激测试量就会下降。
多排螺旋CT在最初的心血管实践中的主要影响在于对应激测试的需求和频率，对心脏导管插入术和冠状动脉介入治疗的使用影响较小。
