冠状动脉钙化评分theagatstoncalciumscore.ppt

Multidetector CT (MDCT) 在心臟血管方面的運用 財團法人新光吳火獅紀念醫院 放射診斷科 Wai-Yip Law Coronary calcification The need to detect coronary atherosclerosis early in its course has been well recognized by cardiologists for decades. The presence and amount of coronary artery calcium have been suggested as a means to assess patients at risk of adverse coronary events. The presence of coronary calcium is always indicative of the presence of coronary atherosclerosis. Agatston et al. developed a calcium scoring algorithm that is now widely used in research and clinical practice. The calcium score is derived from the product of the area of calcification(mm2) and a factor determined by the maximal X-ray density within this area. (calcification should be at least 1 mm2 and the X-ray density should exceed the threshold of 130HU) 冠狀動脈鈣化評分 ”冠狀動脈鈣化評分”  (the Agatston Calcium Score) 之說明 How to use the calcium score? CT calcium quantification can be used for the assessment of long-term risk and primary prevention of future adverse coronary events. Calcium scoring should not be performed as a ‘stand-alone’ test but should be integrated into risk assessment with well recognized risk factors. Risk factors: 1, Sex. 2, Age. 3, Family history. 4, Blood lipids. 5, Smoking. 6, Diabetes. 7, Blood pressure. 8, Weight. Intermediate(1)Calcium score 80 ? Lower risk(2)Calcium score 80 ? Higher risk Electrical Activation of the Heart Retrospective ECG Gating Thanks for you attention! CABG * * coronary artery lumen Plaques LV function LV perfusion Left posterior aortic sinus Left main artery (LM) -- 1- 2 cm Left anterior descending (LAD) 1. Septal branches 2. Diagonal branches Left circumflex artery (LCx) Marginal branches Intermedial artery Left posterior aortic sinus Left main artery (LM) -- 1- 2 cm coronary anatomy Left circumflex artery (LCx) Marginal branches Intermedial artery Anterior aortic sinsus Right coronary artery (RCA) Marginal branches Left anterior descendi