Thakkar Akanksha N, Chinnadurai Ponraj, Lin C Huie
aHouston Methodist Hospital, Houston, Texas bSiemens Medical Solutions, Hoffman Estates, Illinois cHouston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.
Curr Opin Cardiol. 2017 Sep;32(5):503-512. doi: 10.1097/HCO.0000000000000430.
To provide an overview of current recommendations and techniques used to image coarctations of the aorta.
Imaging of coarctation of the aorta in adults is moving away from conventional techniques such as echocardiography and invasive angiography. Echocardiography may assist in making the diagnosis but is limited in its ability to quantify the severity of coarctations. Current guidelines recommend that every patient with a coarctation must undergo a computed tomography (CT) or MRI scan for accurate delineation of morphology. MRIs provide important hemodynamic data and this is rapidly evolving to include techniques such as 4D flow cardiac MRI which can provide time-resolved data; research on using MRIs in the interventional suite is underway. CT is important for surveillance and provides detailed information about repair-site anatomy. Additionally, the use of CT-based technology to guide transcatheter interventions may improve the safety and efficiency of angioplasty and stent deployment.
Although echocardiography is an important first line means to establish the diagnosis of aortic coarctations, CT and MRI-based techniques enable the provision of patient-specific management options, can guide transcatheter interventions and detect long-term post-intervention complications.
概述目前用于主动脉缩窄成像的推荐方法和技术。
成人主动脉缩窄的成像正逐渐摒弃传统技术，如超声心动图和有创血管造影。超声心动图可能有助于做出诊断，但其量化缩窄严重程度的能力有限。当前指南建议，每例主动脉缩窄患者都必须接受计算机断层扫描（CT）或磁共振成像（MRI）扫描，以准确描绘形态。MRI可提供重要的血流动力学数据，并且正在迅速发展，包括如4D流心脏MRI等能够提供时间分辨数据的技术；在介入手术室使用MRI的研究正在进行中。CT对监测很重要，并能提供有关修复部位解剖结构的详细信息。此外，使用基于CT的技术来指导经导管介入治疗可能会提高血管成形术和支架置入的安全性和效率。
尽管超声心动图是诊断主动脉缩窄的重要一线手段，但基于CT和MRI的技术能够提供针对患者的管理方案，可指导经导管介入治疗并检测介入治疗后的长期并发症。
