Scholtz Jan-Erik, Ghoshhajra Brian
Cardiac MR PET CT Program, Department of Radiology (Cardiovascular Imaging) and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Cardiovasc Diagn Ther. 2017 Oct;7(5):439-451. doi: 10.21037/cdt.2017.06.07.
Cardiac computed tomography (CT) imaging has become an important part of modern cardiovascular care. Coronary CT angiography (CTA) is the first choice imaging modality for non-invasive visualization of coronary artery stenosis. In addition, cardiac CT does not only provide anatomical evaluation, but also functional and valvular assessment, and myocardial perfusion evaluation. In this article we outline the factors which influence contrast enhancement, give an overview of current contrast injection and acquisition protocols, with focus on current emerging topics such as pre-transcatheter aortic valve replacement (TAVR) planning, cardiac CT for congenital heart disease (CHD) patients, and myocardial CT perfusion (CTP). Further, we point out areas where we see potential for future improvements in cardiac CT imaging based on a closer interaction between CT scanner settings and contrast injection protocols to tailor injections to patient- and exam-specific factors.
心脏计算机断层扫描(CT)成像已成为现代心血管护理的重要组成部分。冠状动脉CT血管造影(CTA)是无创可视化冠状动脉狭窄的首选成像方式。此外,心脏CT不仅能提供解剖学评估,还能进行功能和瓣膜评估以及心肌灌注评估。在本文中,我们概述了影响对比剂增强的因素,综述了当前的对比剂注射和采集方案,重点关注当前的新兴主题,如经导管主动脉瓣置换术(TAVR)术前规划、先天性心脏病(CHD)患者的心脏CT以及心肌CT灌注(CTP)。此外,基于CT扫描仪设置与对比剂注射方案之间更紧密的相互作用,以根据患者和检查的特定因素定制注射,我们指出了心脏CT成像未来可能改进的领域。