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Dtsch Med Wochenschr 2022; 147(09): 549-556
DOI: 10.1055/a-1554-8450
Dossier

Stellenwert des CT in der kardialen Diagnostik

Cardiac computed tomography – Current diagnostic role in cardiology

Authors

  • Stephan Achenbach

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Aufgrund der schnellen Bewegung des Herzens spielte die CT lange Zeit für die kardiale Bildgebung kaum eine Rolle. Seit allerdings etwa 20 Jahren gestatten speziell ausgerüstete „High-end“-CT-Systeme die Bildgebung des Herzens mit eindrucksvoller Qualität und hoher Aussagekraft. Im Folgenden werden Voraussetzungen und Anwendungsgebiete der CT in der kardialen Diagnostik geschildert: dies unter Erwähnung spezieller Vorteile und auch Limitationen.

Abstract

Computed tomography (CT) imaging of the heart requires specific equipment and protocols in order to synchronize image generation with the electrocardiogram (ECG), usually achieved via ECG-gated reconstruction or ECG-triggered acquisition. The main application of cardiac CT is coronary artery imaging. Contrast-enhanced coronary artery CT allows the identification and rule-out of stenoses and is a diagnostic approach to patients with suspected chronic coronary artery disease or acute chest pain, provided that patient characteristics are associated with a high likelihood of fully diagnostic image quality. In addition, CT has the potential to visualize coronary atherosclerotic plaque, even if non-obstructive, and data suggest that this may be a valuable guide towards more intensive risk modification strategy such as statin therapy. In recent years, the use of CT imaging to guide structural heart interventions has become another important application, and many interventions, such as transcatheter aortic valve implantation, substantially depend on CT imaging to plan the procedure, minimize risks, and optimize outcome.

Schlüsselwörter

Computertomografie - koronare Herzerkrankung - Atherosklerose - Intervention

Key words

computed tomography - coronary artery disease - atherosclerosis - intervention


Publication History

Article published online:
25 April 2022

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