摘要
冠心病是严重影响人类健康的一种常见的重大疾病。在临床症状出现之前及早诊断冠状动脉疾病有着重要的意义。尽管常规冠状动脉造影术仍然是诊断冠心病的“金标准” ,但一些其它非介入技术的应用具有代替常规冠脉造影术的潜在可能性。这样 ,冠状动脉疾病的非介入诊断成为当今医学关心的问题。新一代的多层螺旋CT具有高的分辨率 ,可以对心脏及冠状动脉进行显像评价。它不仅可以直接检测冠脉管腔狭窄 ,而且可以检测冠脉粥样硬化斑块。虽然由于冠脉运动尤其是右冠和回旋支中、远段造成的伪影 ,限制了MSCT的应用 ,但在获得足够的冠脉显像质量的情况下 ,多层螺旋CT冠脉管腔显像诊断明确狭窄的敏感性及特异性达 90 %左右。近几年来 ,CT技术的进步和显像质量的提高为冠脉显像诊断提供了日益增加的临床价值。另一方面 ,多层螺旋CT通过对冠脉钙化的评价 ,进行冠脉斑块负荷的测量 ,可评价、预测心血管病的危险性。通过钙化斑块负荷和造影剂管腔显像结合可增加诊断的准确性。总之 ,MSCT作为评价冠状动脉疾病的非介入方法正在快速发展 ,将来可能成为一种有前途的诊断方法。
Coronary artery disease (CAD) is one of the most common diseases that accounts for a considerable part of health.Early diagnosis of CAD is important before the presence of clinical symptoms.Though the gold standard for direct diagnostic imaging of CAD is still conventional X-ray coronary angiography,several other applications of noninvasive techniques have potentiality to substitute it.Thus,noninvasive diagnosis of CAD is important to medical care today.The recent generation of multislice computed tomography scanners (MSCT) permit high-resolution imaging of the beating heart and the coronary arteries.MSCT permits direct visualization of not only coronary artery stenosis but also atherosclerotic plaques in patients with coronary artery disease.Image artifacts due to rapid motion,especially in the distal segments of the right and circumflex coronary arteries,may limit the application of MSCT.With sufficient evaluation of cardiac artery vessels,MSCT lumenography permits visualization of significant coronary stenosis with a sensitivity and specificity of about 90%.Technical advances in recent years and improvements in image quality in MSCT brought along an increasing interest in the potential clinical role of noninvasive computed tomographic coronary angiography (CTCA).On the other hand,MSCT permits reliable estimation of coronary calcification and quantification of overall coronary plaque burden and thereby allows risk assessment to predict the individual cardiovascular risk.Diagnostic accuracy may be enhanced by combining assessment of calcified plaque burden and contrast imaging.Generally,MSCT is developing rapidly as a noninvasive method for assessing CAD,and is a prospective method in diagnosing CAD in future.
出处
《心血管病学进展》
CAS
2004年第4期248-252,共5页
Advances in Cardiovascular Diseases
基金
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