Liu Chung-Pin, Lin Yen-Hung, Lin Mao-Shin, Huang Wei-Chun, Lin Shoa-Lin
Chung-Pin Liu, Shoa-Lin Lin, Department of Internal Medicine, Yuan's General Hospital, Kaohsiung 802, Taiwan.
World J Cardiol. 2013 Apr 26;5(4):115-8. doi: 10.4330/wjc.v5.i4.115.
Multidetector-row computed tomography (MDCT) has become one of the major tools in diagnosing and evaluating patients with coronary artery disease in recent years. In selected patients, MDCT has been shown to provide more reliable accuracy in detection of stent patency than invasive coronary angiography. Chiou et al reported a delicate infarcted myocardium at-risk score. According to their results, the MDCT-based myocardium at-risk score had a good correlation with the thallium 201 ST-segment elevation myocardial infarction-based summed difference score (r = 0.841, P < 0.001). They claimed that dual-phase MDCT is useful in detecting different patterns of obstructive lesions and the extent of myocardium at risk. In this commentary, we discuss the current status of the clinical application of MDCT in patients with myocardial infarction in relation to evaluating the myocardial perfusion defect, detecting reversible myocardial ischemia, assessing myocardial viability, estimating target lesion restenosis, and calculating of fractional flow reserve from MDCT.
近年来，多排螺旋计算机断层扫描（MDCT）已成为诊断和评估冠心病患者的主要工具之一。在特定患者中，MDCT已被证明在检测支架通畅性方面比有创冠状动脉造影具有更高的准确性。Chiou等人报告了一个精细的梗死心肌危险评分。根据他们的结果，基于MDCT的心肌危险评分与基于铊201 ST段抬高型心肌梗死的总差异评分具有良好的相关性（r = 0.841，P < 0.001）。他们声称双期MDCT有助于检测不同类型的阻塞性病变以及危险心肌的范围。在这篇评论中，我们讨论了MDCT在心肌梗死患者临床应用中的现状，涉及评估心肌灌注缺损、检测可逆性心肌缺血、评估心肌存活能力、估计靶病变再狭窄以及从MDCT计算血流储备分数。
