临床定量冠状动脉狭窄和冠状动脉样硬化成像:来自定量心血管成像研究小组的共识声明
Aldo J Vázquez Mézquita1, Federico Biavati1, Volkmar Falk2,3,4
1Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Nature reviews. Cardiology
|June 5, 2023
概括
选择正确的成像技术对于诊断冠状动脉疾病至关重要. 这份共识声明指导临床医生最佳使用CT,MRI,PET,SPECT以及狭窄和动脉样硬化评估的侵入性方法.
科学领域:
- 心血管成像 - 心血管成像
- 医学诊断 医学诊断 医学诊断
- 干预心脏病学 干预心脏病学
背景情况:
- 准确检测和描述冠状动脉狭窄和动脉样硬化对于患者管理至关重要.
- 优化成像模式选择可以提高冠状动脉疾病的诊断,治疗和程序规划.
研究的目的:
- 为冠状动脉疾病的各种成像技术的最佳使用提供临床共识建议.
- 描述心血管成像技术的进步.
主要方法:
- 一个由三个步骤组成的,实时的Delphi过程,涉及国际专家.
- 从调查回复中得出的建议,主要的心血管成像会议之前,期间和之后.
主要成果:
- 建议CT用于排除中等风险患者的阻塞性狭窄症,提供斑块量化.
- 在经验丰富的中心,MRI作为无辐射的二线选择,用于非侵入性血管造影.
- PET显示了斑块炎症量化潜力;SPECT的作用有限.
- 侵入性方法,如血管内超声波和光学连贯性断层扫描,是高风险斑块识别的关键.
结论:
- "共识声明"为根据临床背景,患者因素和可用性选择最合适的成像模式提供了指导.
- 这些建议旨在改善评估冠状动脉狭窄和动脉样硬化的临床决策过程.
相关概念视频
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
43
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
43
Acute Coronary Syndrome III: Diagnostic Studies
11
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
11
Imaging Studies for Cardiovascular System V: CT
45
Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
45
Imaging Studies for Cardiovascular System III: X-Ray
219
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
219
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
16
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
16
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
22
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
22


