Sun Zhong-Hua
Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, Australia.
Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth 6012, Australia.
J Geriatr Cardiol. 2024 May 28;21(5):550-576. doi: 10.26599/1671-5411.2024.05.002.
Cardiovascular computed tomography angiography (CTA) is a widely used imaging modality in the diagnosis of cardiovascular disease. Advancements in CT imaging technology have further advanced its applications from high diagnostic value to minimising radiation exposure to patients. In addition to the standard application of assessing vascular lumen changes, CTA-derived applications including 3D printed personalised models, 3D visualisations such as virtual endoscopy, virtual reality, augmented reality and mixed reality, as well as CT-derived hemodynamic flow analysis and fractional flow reserve (FFRCT) greatly enhance the diagnostic performance of CTA in cardiovascular disease. The widespread application of artificial intelligence in medicine also significantly contributes to the clinical value of CTA in cardiovascular disease. Clinical value of CTA has extended from the initial diagnosis to identification of vulnerable lesions, and prediction of disease extent, hence improving patient care and management. In this review article, as an active researcher in cardiovascular imaging for more than 20 years, I will provide an overview of cardiovascular CTA in cardiovascular disease. It is expected that this review will provide readers with an update of CTA applications, from the initial lumen assessment to recent developments utilising latest novel imaging and visualisation technologies. It will serve as a useful resource for researchers and clinicians to judiciously use the cardiovascular CT in clinical practice.
心血管计算机断层扫描血管造影(CTA)是诊断心血管疾病中广泛使用的一种成像方式。CT成像技术的进步进一步推动了其应用,从具有高诊断价值发展到将患者的辐射暴露降至最低。除了评估血管腔变化的标准应用外,CTA衍生的应用包括3D打印个性化模型、3D可视化(如虚拟内窥镜检查、虚拟现实、增强现实和混合现实),以及CT衍生的血流动力学分析和血流储备分数(FFRCT),极大地提高了CTA在心血管疾病中的诊断性能。人工智能在医学中的广泛应用也显著提升了CTA在心血管疾病中的临床价值。CTA的临床价值已从最初的诊断扩展到识别易损病变以及预测疾病范围,从而改善患者护理和管理。在这篇综述文章中,作为一名从事心血管成像研究20多年的活跃研究者,我将概述心血管CTA在心血管疾病中的应用。预计这篇综述将为读者提供CTA应用的最新情况,从最初的管腔评估到利用最新的新型成像和可视化技术的最新进展。它将成为研究人员和临床医生在临床实践中明智使用心血管CT的有用资源。