基本的ESR:在稳定的胸痛中成像-ESCR的实践建议
Giuseppe Muscogiuri1, Jonathan R Weir-McCall2,3, Mariia Tregubova4
1Department of Radiology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy. gmuscogiuri@asst-pg23.it.
非侵入性成像帮助通过评估冠状动脉疾病 (CAD) 来诊断稳定的胸痛. 冠状动脉CT血管造影通常是第一线测试,而功能成像在不确定的情况下是有用的.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 诊断医学 诊断医学
背景情况:
- 稳定的胸痛是各种病因的常见症状.
- 非侵入性成像对于诊断冠状动脉疾病 (CAD),评估斑块和评估心脏功能至关重要.
- 计算机断层扫描 (CT) 提供了对CAD的解剖学见解,包括狭窄和斑块负担,CT-FFR或 perfusion 成像的功能数据.
研究的目的:
- 为在患有稳定胸痛的患者中选择非侵入性成像测试提供实践建议.
- 指导诊断成像程序的执行和报告.
- 优化诊断途径,以获得稳定的胸痛评估.
主要方法:
- 对稳定胸痛的非侵入性成像方法的审查.
- 冠状动脉CT血管造影 (CCTA) 作为一线诊断工具的评估.
- 评估功能性成像技术,如压力MRI,SPECT,PET和心声回声.
主要成果:
- 建议使用CCTA作为一线测试,用于患有低至中等CAD前测试概率的患者.
- 对于已知具有不确定的临床意义或高预测概率的CAD患者,功能测试是适用的.
- 图像选择应以患者的症状,测试前的概率和病史为指导.
结论:
- 非侵入性成像在全面评估稳定的胸痛方面发挥着关键作用.
- 在解剖 (CCTA) 和功能成像之间做出选择取决于个体患者的特征和临床背景.
- 证据支持CCTA作为一个高水平的证据第一线测试,用于许多患有稳定的胸痛的患者.
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