Lackner K, Landwehr P, Thurn P
Institut für Röntgendiagnostik, Universität Würzburg, BRD.
Int J Card Imaging. 1988;3(1):39-45. doi: 10.1007/BF01801643.
Ungated cardio-CT provides good morphologic information in the case of congenital heart disease, volume or pressure loading, left ventricular aneurysm, tumours, thrombi, cardiac calcifications and pericardial diseases. It allows qualitative assessments of myocardial thickness and perfusion of coronary bypass grafts. ECG-gated cardio-CT allows a quantitative assessment of systolic and diastolic myocardial thickness, volume calculation of cardiac cavities and evaluation of functional parameters. The correlation of the calculated left ventricular ejection fraction comparing laevocardiography and ECG-gated cardio-CT was poor (r = 0.7) mainly due to the comparable poor time resolution on the side of cardio-CT (approximately 0.1s). The quantitative analysis of regional wall motion based on cardio-CT showed for the diagnosis of pathologic wall motion a specificity of 80.5%, sensitivity of 73.9% and accuracy of 75.7%. Side effects must be taken into account following the injection of 200-250 ml hyperosmolar contrast medium during 5-10 minutes which causes intravascular fluid retention and cardiac volume loading. Patients prone to cardiac decompensation should be excluded from cardio-CT examinations.
非门控心脏CT在先天性心脏病、容量或压力负荷、左心室动脉瘤、肿瘤、血栓、心脏钙化和心包疾病的情况下可提供良好的形态学信息。它可以对心肌厚度和冠状动脉搭桥术的灌注进行定性评估。心电图门控心脏CT可以对收缩期和舒张期心肌厚度进行定量评估、计算心腔容积并评估功能参数。通过心脏超声心动图和心电图门控心脏CT计算左心室射血分数的相关性较差（r = 0.7），主要原因是心脏CT的时间分辨率较差（约0.1秒）。基于心脏CT的室壁运动定量分析显示，病理性室壁运动诊断的特异性为80.5%，敏感性为73.9%，准确性为75.7%。在5至10分钟内注射200 - 250毫升高渗造影剂后必须考虑副作用，这会导致血管内液体潴留和心脏容量负荷增加。易于发生心脏失代偿的患者应排除在心脏CT检查之外。
