Kohsaka Shun, Makaryus Amgad N
Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan, North Shore University Hospital, Manhasset, NY, USA.
Curr Cardiol Rev. 2008 Nov;4(4):323-30. doi: 10.2174/157340308786349444.
Noninvasive coronary angiography has become an important imaging tool in the evaluation of patients with and at risk for coronary artery disease (CAD). Multidetector computed tomographic (MDCT) angiography offers excellent negative predictive value (>/=95%) for the absence of coronary artery disease and has shown promising results in evaluating allograft vasculopathy, bypass grafts, and degenerative aortic valve disease. A single MDCT scan in the emergency department is valuable in ruling out both cardiac and noncardiac causes of acute chest pain. Cardiac magnetic resonance (MR) currently lacks the spatial resolution of MDCT limiting its assessment of the coronary vasculature, but the proximal coronary arteries can be evaluated along with myocardial function and viability without exposure to contrast dye or ionizing radiation. In addition, MR imaging also has great potential for characterizing coronary plaques, as well as following their progression and regression.
无创冠状动脉造影已成为评估冠心病患者及冠心病高危患者的一项重要成像工具。多排螺旋计算机断层扫描(MDCT)血管造影对排除冠状动脉疾病具有出色的阴性预测价值(≥95%),并且在评估移植血管病变、搭桥血管以及退行性主动脉瓣疾病方面已显示出有前景的结果。在急诊科进行一次MDCT扫描对于排除急性胸痛的心脏和非心脏病因很有价值。心脏磁共振(MR)目前缺乏MDCT的空间分辨率,限制了其对冠状动脉系统的评估,但无需使用造影剂或电离辐射即可评估近端冠状动脉以及心肌功能和存活性。此外,MR成像在冠状动脉斑块的特征描述以及跟踪其进展和消退方面也具有巨大潜力。