冠脉CT血管造影在冠状动脉疾病临床应用-影像医学与核医学专业毕业论文.pdfVIP

冠脉CT血管造影在冠状动脉疾病的临床应用 中文摘要 【摘要】 在我国，冠状动脉疾病（CAD ）是一个常见的导致死亡的疾病，经过 几十年，冠状动脉疾病死亡率下降，但急性冠脉综合征发病率继续上升。冠状动 脉CT血管造影（冠脉CTA ）是准确判断冠状动脉疾病的一个安全无创评价测试 工具。虽然冠状动脉造影是冠心病的金标准，但有充分的证据来支持冠脉CTA的 性价比，而且它的临床应用范围广, 它不仅能判断冠状动脉狭窄程度，冠状动脉 起源异常、走行变异和终止异常，给予冠状动脉介入术术前指导及明确评估治疗 后疗效，随访冠状动脉搭桥术后桥血管的通畅情况；也能分流急性胸痛患者，提 高诊断时效性，及时选择合适的治疗方法。冠脉CTA在心脏成像技术的发展,不 断改善的空间和时间分辨率，显示出高灵敏度和特异性及一个非常高的阴性预测 值。对于筛选病人很有价值，特别是疑似冠状动脉疾病的患者，并在疾病的进展 和心脏事件预测上已发挥了重要的作用。使用冠脉CTA可减少胸痛患者的医疗费 用和急诊室的等待长度。本次综述的目的是介绍在冠状动脉疾病临床应用中冠脉 CTA 的诊断准确性和预测价值以及冠状动脉疾病的定义，流行病学，病因和发病 机制，临床表现及并发症，治疗和预后的概述；对冠脉CTA的新兴领域，包括双 源CT、256和320排螺旋CT进行讨论；以及强调冠脉CT血管造影的局限性和未来 的发展方向，已预测其将发展为一种模式，取代以往的诊断方法。 【关键词】冠状动脉CT血管造影；冠状动脉疾病；双源CT ；冠状动脉造影术 5 Coronary CT angiography in the clinical application of coronary artery disease Abstract Coronary artery disease (CAD) is the single common cause of death in China. After decades of declining CAD death rates, the incidence of acute coronary syndromes has continued to rise. Coronary CT angiography (CCTA) is a safe noninvasive evaluation of test tools to accurately delineate coronary artery disease. Although coronary artery angiography is the gold standard for coronary heart disease, but there is ample evidence to support the cost of CCTA, and its wide range of clinical applications. It is not only able to judge the degree of coronary stenosis, anomalous origin of coronary artery course variation and to terminate the exception given to precutaneous coronary intervention after preoperative guidance and a clear assessment of treatment efficacy, follow-up after coronary artery bypass grafts patency; can shunt patients with acute chest pain, and improve the diagnosis of timeliness, select the appropriate and timely treatment. Coronary CT angiography represents a technological evolution in cardiac imaging due to improved spat