[Comprehensive cardiac imaging using multidetector CT and magnetic resonance imaging].

B Gerber
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引用次数: 0

Abstract

Recent technical improvements have allowed to non-invasive cardiac imaging by Multidetector CT. (MDCT). In initial work we compared the value of successive generations of MDCT (4, 16, and 64 slice) for non-invasive imaging of coronary arteries vs. non-invasive magnetic resonance coronary angiography using conventional coronary angiography as gold standard. Our work demonstrated progressive improvement of diagnostic accuracy from 4 to 64 slice MDCT technology. The most recent generation of 64 slice MDCT became more performing than MRI. Since cardiac function is the main predictor of outcome in patients with coronary artery disease, we evaluated whether MDCT can also access left ventricular volumes and ejection fraction, and observed excellent correlation of these parameters estimated by MDCT vs MRI. Subsequently we demonstrated that MDCT can also assess aortic stenosis by direct planimetry of the valve. We also found MDCT to be able of evaluating the severity and mechanism of aortic regurgitation and to evaluate function and mechanism of dysfunction of aortic bioprosthesis. We also demonstrated that MDCT can detect myocardial necrosis and fibrosis, and thus assess myocardial viability using similar mechanisms as MRI. Finally, we demonstrated that combined assessment of non-invasive coronary imaging and assessment of myocardial viability may allow assessing the etiology of ischemic vs non-ischemic heart failure, similarly well as the combination of mri and invasive coronary angiography. We also demonstrated that MDCT might allow avoiding performing systematic invasive coronary angiography in patients prior to valve surgery, by selecting only those patients with suspected coronary artery disease to undergo this test. Thus in summary, we performed work, demonstrating the value of MDCT not only for imaging of coronary arteries, but also for assessment of cardiac and valve function and evaluation of myocardial viability. Such comprehensive cardiac imaging by MDCT might be useful for assessment of patients with valve disease and to evaluate etiology of heart failure.

[多探头CT和磁共振综合心脏成像]。
最近的技术进步已经允许通过多探测器CT进行无创心脏成像。(MDCT)。在最初的工作中,我们比较了连续几代MDCT(4,16和64层)对冠状动脉无创成像的价值与以常规冠状动脉造影为金标准的无创磁共振冠状动脉造影的价值。我们的研究表明,从4层到64层多层螺旋ct技术的诊断准确性逐步提高。最新一代64层多层螺旋ct比MRI表现更好。由于心功能是冠状动脉疾病患者预后的主要预测因素,我们评估了MDCT是否也可以获得左心室容量和射血分数,并观察到MDCT与MRI估计的这些参数具有良好的相关性。随后,我们证明了多层螺旋ct也可以通过直接测量主动脉瓣的平面来评估主动脉狭窄。我们还发现MDCT能够评估主动脉反流的严重程度和机制,以及评估主动脉生物假体的功能和功能障碍机制。我们还证明了MDCT可以检测心肌坏死和纤维化,从而使用与MRI相似的机制评估心肌活力。最后,我们证明了联合评估无创冠状动脉成像和心肌活力评估可以评估缺血性和非缺血性心力衰竭的病因,类似于mri和有创冠状动脉造影的结合。我们也证明了MDCT可以避免在瓣膜手术前对患者进行系统的侵入性冠状动脉造影,只选择那些疑似冠状动脉疾病的患者进行这项检查。综上所述,我们所做的工作证明了MDCT不仅在冠状动脉成像方面有价值,而且在心脏和瓣膜功能评估以及心肌活力评估方面也有价值。这种全面的MDCT心脏成像可能有助于评估瓣膜疾病患者和评估心力衰竭的病因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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