Alani Anas, Nakanishi Rine, Budoff Matthew J
Department of Cardiology, Harbor-UCLA Medical Center, Los Angeles, California.
Clin Cardiol. 2014 Jul;37(7):428-33. doi: 10.1002/clc.22286. Epub 2014 Apr 22.
Although invasive coronary angiography has been the gold standard for evaluating coronary artery disease (CAD), it should not be routinely performed as an initial test to assess CAD in subjects with suspected CAD by the recent guidelines, due to cost, invasiveness, and measurable risk. Coronary computed tomography angiography (CCTA) is a rapidly growing, noninvasive imaging modality that developed quickly over the last decade, and its role for evaluation of CAD becomes of great promise with high diagnostic accuracy. Although artifact issues have created some challenges for CCTA, recent advances-including the introduction of more detectors, leading to broader coverage, and faster and higher-definition scanners-allow improved precision and fewer uninterpretable studies. This review article summarizes the current key literature regarding the diagnostic accuracy of CCTA in native coronary arteries, stents, coronary artery bypass grafts, lesions with high calcification, and the functional assessment of CAD.
尽管有创冠状动脉造影一直是评估冠状动脉疾病(CAD)的金标准,但根据最近的指南,由于成本、侵入性和可测量的风险,对于疑似CAD的患者,不应将其作为评估CAD的初始常规检查。冠状动脉计算机断层扫描血管造影(CCTA)是一种快速发展的非侵入性成像方式,在过去十年中发展迅速,其在CAD评估中的作用因具有高诊断准确性而前景广阔。尽管伪影问题给CCTA带来了一些挑战,但最近的进展——包括引入更多探测器从而实现更广泛的覆盖范围,以及更快、更高清晰度的扫描仪——提高了精度,减少了无法解读的研究。这篇综述文章总结了目前关于CCTA在天然冠状动脉、支架、冠状动脉旁路移植术、高钙化病变以及CAD功能评估方面诊断准确性的关键文献。