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冠状动脉疾病诊断中钙评分与心肌闪烁显像的关系

Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease.

作者信息

Siqueira Fabio Paiva Rossini, Mesquita Claudio Tinoco, Santos Alair Augusto Sarmet M Damas Dos, Nacif Marcelo Souto

机构信息

Programa de Pós-graduação em Ciências Cardiovasculares, Universidade Federal Fluminense, Niterói, RJ, Brazil.

Departamento de Radiologia, Faculdade de Medicina, Universidade Federal Fluminense, Brazil.

出版信息

Arq Bras Cardiol. 2016 Oct;107(4):365-374. doi: 10.5935/abc.20160104. Epub 2016 Jul 18.

Abstract

Half the patients with coronary artery disease present with sudden death - or acute infarction as first symptom, making early diagnosis pivotal. Myocardial perfusion scintigraphy is frequently used in the assessment of these patients, but it does not detect the disease without flow restriction, exposes the patient to high levels of radiation and is costly. On the other hand, with less radiological exposure, calcium score is directly correlated to the presence and extension of coronary atherosclerosis, and also to the risk of cardiovascular events. Even though calcium score is a tried-and-true method for stratification of asymptomatic patients, its use is still reduced in this context, since current guidelines are contradictory to its use on symptomatic diseases. The aim of this review is to identify, on patients under investigation for coronary artery disease, the main evidence of the use of calcium score associated with functional evaluation and scintigraphy.

摘要

半数冠心病患者首发症状为猝死或急性心肌梗死,因此早期诊断至关重要。心肌灌注闪烁扫描常用于评估这些患者,但它无法检测出无血流受限的疾病,会使患者暴露于高水平辐射且费用高昂。另一方面,钙评分的放射学暴露较少,与冠状动脉粥样硬化的存在和范围直接相关,也与心血管事件风险相关。尽管钙评分是对无症状患者进行分层的可靠方法,但在这种情况下其应用仍然较少,因为现行指南与将其用于有症状疾病的做法相矛盾。本综述的目的是在接受冠状动脉疾病检查的患者中,确定与功能评估和闪烁扫描相关的钙评分应用的主要证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3a8/5102483/15bd5f613bc0/abc-107-04-0365-g01.jpg

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