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在急性冠状动脉综合征的多模式非侵入性成像方法:诊断和预后评估
Daniele Cavallo1,2, Luca Bergamaschi1,3, Francesco Angeli1,3
1Department of Medical and Surgical Sciences-DIMEC-Alma Mater Studiorum, University of Bologna, Bologna, 40138, Italy.
像TTE,CCTA和CMR这样的非侵入性成像可以有效地管理疑似急性冠状动脉综合征 (ACS). 这些技术有助于选择合适的诊断测试,减少不必要的侵入性手术.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
背景情况:
- 急性冠状动脉综合征 (ACS) 的诊断和管理存在挑战.
- 将ACS与其他疾病区分开来需要仔细选择诊断测试.
研究的目的:
- 审查非侵入性多式成像在疑似ACS中的作用.
- 划出跨胸腔心声学 (TTE),冠状动脉计算机断层扫描血管学 (CCTA),心脏磁共振 (CMR) 和核成像是最佳的场景.
主要方法:
- 对当前证据和指导方针进行叙述性审查.
- 在ACS诊断中对非侵入性成像技术的分析.
主要成果:
- TTE可以识别墙壁运动异常;斑点跟踪可以提高灵敏度.
- CCTA提供高负预测值和斑块分析.
- CMR有助于MINOCA诊断和NSTEMI工作,具有预后价值.
- 核成像检测出缺血和心脏病发作,支持安全的出院.
结论:
- 非侵入性成像在低前测试概率的ACS,低风险的NSTEMI,排除替代品和MINOCA诊断中是有价值的.
- 这些技术减少了不必要的侵入性冠状动脉血管学 (ICA).
- 实际建议的目的是尽量减少冗余,昂贵和危险的程序.
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