VZL 2008, 77(2):43-49
MSCT-Coronarography - Contributions in Noninvasive Cardiologic Diagnostics
- Interné oddelenie, Nemocnica Ministerstva obrany, Bratislava, Slovenská republika
- Rádiodiagnostické oddelenie, Nemocnica Ministerstva obrany, Bratislava, Slovenská republika
Najnovším pokrokom v oblasti zobrazenia srdca je neinvazívna elektrokardiograficky synchronizovaná angiografia multidetektorovou špirálovou computerovou tomografiou (MSCT). Z možností MSCT v neinvazívnej kardiológii využívame 2 základné klinické aplikácie: stanovenie kalciového skóre a kontrastnú angiografiu epikardiálnych koronárnych ciev.
MSCT koronarografia má potenciál vylúčiť alebo potvrdiť koronárny postih. Otvára možnosť nielen vizualizovať stenózy, ale aj diferencovať morfológiu plátu a stanoviť jeho charakter, rozsah a závažnosť. Je významným pokrokom v kardiologickej diagnostike a prínosom pre ďalší manažment pacientov. Ako alternatívna metóda selektívnej koronarografie (SKG) má aj výrazný medicínsky a ekonomický dopad, spočívajúci v znížení počtu "zbytočne realizovaných" negatívnych SKG a tým uvolnením kapacity pre reálne potrebné výkony, ale aj v možnosti realizácie angioplastiky na jedno sedenie pri už vytvorenej predstave o stave koronárnej cirkulácie pomocou MSCT nálezu. Pri súčasnom počte a kapacite katetrizačných pracovísk na Slovensku je táto potreba viac ako aktuálna.
Keywords: MSCT; Kalciové skóre; Koronárne cievy; Selektívna koronarografia
The most recent contribution in the field of heart imaging is electrocardiographically synchronized angiography executed through Multidetector Spiral Computerized Tomography (MSCT). From the vast area of clinical applications in noninvasive cardiology, we use two basic ones- the setting of calcium levels and mainly the contrasting angiography of epicardial coronary vessels.MSCT coronarography has the potential to eliminate or to confirm coronary damage. It opens up a new possibility not only to visualize stenosis, but also to differentiate morphology of the plate and to set its character, scope and importance. MSCT coronarography brings important progress to cardiological diagnostics and contributes positively to further management of patients as an alternative method of selective coronarography (SKG), MSCT has a significant medical and economic impact consisting mostly of the elimination of "wastingly done" negative SKG's. This elimination will free the capacity for really necessary procedures. It will also give the possibility of doing a percutaneous transluminal coronary angioplasty in one sitting, based on previously created idea of the state in which the coronary circulation finds itself diagnosed through MSCT. The need for the above described changes is a hot issue due to the present lack of catheterization workplaces in Slovakia.
Keywords: MSCT; Calcium levels; Coronary vessels; Selective coronarography
Received: May 14, 2007; Published: June 1, 2008 Show citation
References
- RIENMÜLLER, R. Non-invasive coronary artery imaging. ECR, Wienna, 2002.
- EKSTROM, JE. Coronary Calcium Scoring. Oregon Imaging Network-Winter, 2001.
- PREČINSKÝ, P. - MISTRÍK, J. - MARTINKOVIČ, M., et al. MDCT zobrazenie koronárnych artérií. Čes. Radiol., 2003, roč. 57, s. 285-294.
- SULLIVAN, GW. - SARENBOCK, IJ. - LINDEN, J. The role of inflamation in vascular diseases. J. Leukoc. Biol., 2000, vol. 87, p. 591-600.
Go to original source... 
Go to PubMed... - GIMBRONE, MA. Endothelial dysfunction, hemodynamic forces an atherosclerosis. Thromb. Haemostat., 2001, vol. 82, p. 722-726. Go to original source...
- MORENO, PR., et al. Macrophages, smooth muscle cells and tissue factor in unstable angina. Circulation, 2002, vol. 102, p. 3090-3097. Go to original source...
- MARTINKOVIČ, M., et al. Multidetektorová špirálová počítačová tomografia - prvé klinické skúsenosti na Slovensku. Cardiol., 2005, roč. 14, č. 2, s. 81-87.
- MARTINKOVIČ, M. - PREČINSKÝ, P. Multidetektorová špirálová computerová tomografická koronarografia a jej prínos v neinvazívnej kardiologickej diagnostike. Inter. Med., 2005, roč. 2, s. 95-99.
- LEBER, AW., et al. Accuracy of 64-slice computed tomography to classify and quantify plaque volumes in the proximal coronary system: a comparative study using intravascular ultrasound. J. Am. Coll. Cardiol., 2006, vol. 47, p. 672-677. Go to original source... Go to PubMed...
- SCHRODER, S., et al. Non-invasive characterisation of coronary lesion morphology by multislice computed tomography: a promising new technology for risk stratification of patients with coronary artery disease. Heart, 2001, vol. 85, p. 576-578. Go to original source...
- KOPP, AF., et al. Non-invasive chracterisation of coronary lesion morphology and composition by multislice computed tomography. Eur. Radiol., 2001, vol. 11, p. 1607-1611. Go to original source... Go to PubMed...
- SCHRODER, S., et al. Non-invasive detection and evaluation of atherosclerotic plaques with multi-slice computed tomography. JACC, 2001, vol. 37, p. 1430-1435. Go to original source... Go to PubMed...
- SCHRODER, S., et al. Accuracy and reliability of quantitative measurements in coronary arteries by multi-slice computed tomography: experimental and initial clinical results. Clin. Radiol., 2001, vol. 56, p. 466-474. Go to original source... Go to PubMed...
- NIEMAN, K., et al. Coronary angiography with multi-slice computed tomography. Lancet, 2001, vol. 357, p. 599-603. Go to original source... Go to PubMed...
- ACHENBACH, S., et al. Value of electron-beam computed tomography for non-invasive detection of high-grade coronary artery stenoses and occlusions. N. Eng. J. Med., 1988, vol. 339, p. 1964-1971. Go to original source...
- ACHENBACH, S., et al. Detection of coronary artery stenose by contrast-enhanced, retrospectively electrocardiographically- gated, multi-slice spiral computed tomography. Circulation, 2001, vol. 103, p. 2535-2538. Go to original source... Go to PubMed...
- KOOP, AF., et al. Multidetektor-row CT for the non-invasive detection of high-grade coronary artery stenoses and occlusions. Eur. Radiol., 2000, vol. 10, no. 2 (Suppl 1), p. 284.
- NIEMAN, K., et al. Tree-dimensional coronary anatomy in contrast- enhanced multi-slice computed tomography (MSCT). Prev. Cardiol., 2002, vol. 5, no. 2, p. 79-83. Go to original source... Go to PubMed...
- NIEMAN, K., et al. Reliable noninvasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation, 2002, vol. 106, p. 2051-2054. Go to original source... Go to PubMed...
- ROPERS, D., et al. Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. Circulation, 2003, vol. 107, p. 664-666. Go to original source... Go to PubMed...
- FERENCIK, M., et al. Quantitative parameters of image quality in multidetector spiral computed tomographic coronary imaging with submillimeter collimation. Am. J. Cardiol., 2003, vol. 92, p. 1257-1262. Go to original source... Go to PubMed...
- NIEMAN, K., et al. Coronary angiography with multi-slice computed tomography. Lancet, 2001, vol. 357, p. 599-603. Go to original source... Go to PubMed...
- HOFFMANN, U., et al. Predictive value of 16-slice multi-detector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease: Patient-versus segment-based analysis. Circulation, 2004, vol. 110, p. 2638-2643. Go to original source... Go to PubMed...