Kardiologie up2date 2009; 5(3): 219-226
DOI: 10.1055/s-0029-1215273
Hotline – Bildgebung und interventionelle Techniken

© Georg Thieme Verlag KG Stuttgart · New York

Klinische Wertigkeit der Herzdiagnostik mittels Multislice-CT und kardialer MRT

Thorsten  Dill, Andreas  Rolf
Further Information

Publication History

Publication Date:
15 October 2009 (online)

Abstract

Advances on the field of CMR and MSCT have greatly contributed to improve differentialdiagnosis in cardiology. Both tools yield valuable information in the diagnosis of coronary heart disease and cardiomyopathies, CMR has become gold standard for the evaluation of stress induced ischemia. We also see a growing role in guiding interventions such as revascularisation procedures, electrophysiology or percutaneous valve replacement. Profound knowledge of indications and limitations of both procedures should become an integral part of training in cardiology. This article reviews established and newer indications of both tools based on current guidlines and recommendations.

Literatur

  • 1 Schroeder S, Achenbach S, Bengel F. et al . Cardiac computed tomography: indications, applications, limitations, and training requirements: report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology.  Eur Heart J. 2008;  29 531-556
  • 2 Nagel E, Bauer W, Sechtem U. et al . Klinische Indikationen für die kardiovaskuläre Magnetresonanztomographie (CMR).  Clin Res Cardiol(Suppl). 2007;  2 77-96
  • 3 Hendel R C, Patel M R, Kramer C M. et al . ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology.  J Am Coll Cardiol. 2006;  48 1475-1497
  • 4 Budoff M J, Achenbach S, Blumenthal R S. et al . Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology.  Circulation. 2006;  114 1761-1791
  • 5 Alkadhi H, Scheffel H, Desbiolles L. et al . Dual-source computed tomography coronary angiography: influence of obesity, calcium load, and heart rate on diagnostic accuracy.  Eur Heart J. 2008;  29 766-776
  • 6 Rybicki F J, Otero H J, Steigner M L. et al . Initial evaluation of coronary images from 320-detector row computed tomography.  Int J Cardiovasc Imaging. 2008;  24 535-546
  • 7 Budoff M J, Dowe D, Jollis J G. et al . Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial.  J Am Coll Cardiol. 2008;  52 1724-1732
  • 8 Meijboom W B, Meijs M F, Schuijf J D. et al . Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study.  J Am Coll Cardiol. 2008;  52 2135-2144
  • 9 Miller J M, Rochitte C E, Dewey M. et al . Diagnostic performance of coronary angiography by 64-row CT.  N Engl J Med. 2008;  359 2324-2336
  • 10 Leber A W, Becker A, Knez A. 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;  47 672-677
  • 11 Schwitter J, Wacker C M, van Rossum A C. et al . MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial.  Eur Heart J. 2008;  29 480-489
  • 12 Nagel E, Lehmkuhl H B, Bocksch W. et al . Noninvasive diagnosis of ischemia-induced wall motion abnormalities with the use of high-dose dobutamine stress MRI: comparison with dobutamine stress echocardiography.  Circulation. 1999;  99 763-770
  • 13 Jahnke C, Nagel E, Gebker R. et al . Prognostic value of cardiac magnetic resonance stress tests: adenosine stress perfusion and dobutamine stress wall motion imaging.  Circulation. 2007;  115 1769-1776
  • 14 Pilz G, Jeske A, Klos M. et al . Prognostic value of normal adenosine-stress cardiac magnetic resonance imaging.  Am J Cardiol. 2008;  101 1408-1412
  • 15 Kim R J, Wu E, Rafael A. et al . The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction.  N Engl J Med. 2000;  343 1445-1453
  • 16 Germans T, van Rossum A C. The use of cardiac magnetic resonance imaging to determine the aetiology of left ventricular disease and cardiomyopathy.  Heart. 2008;  94 510-518
  • 17 Kim R J, Fieno D S, Parrish T B. et al . Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function.  Circulation. 1999;  100 1992-2002
  • 18 Wu E, Ortiz J T, Tejedor P. et al . Infarct size by contrast enhanced cardiac magnetic resonance is a stronger predictor of outcomes than left ventricular ejection fraction or end-systolic volume index: prospective cohort study.  Heart. 2008;  94 730-736
  • 19 Cury R C, Shash K, Nagurney J T. et al . Cardiac magnetic resonance with T2-weighted imaging improves detection of patients with acute coronary syndrome in the emergency department.  Circulation. 2008;  118 837-844
  • 20 Lardo A C, Cordeiro M A, Silva C. et al . Contrast-enhanced multidetector computed tomography viability imaging after myocardial infarction: characterization of myocyte death, microvascular obstruction, and chronic scar.  Circulation. 2006;  113 394-404
  • 21 Friedrich M G, Sechtem U, Schulz-Menger J. et al . Cardiovascular magnetic resonance in myocarditis: A JACC White Paper.  Journal of the American College of Cardiology. 2009;  53 1475-1487
  • 22 Folsom A R, Kronmal R A, Detrano R C. et al . Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: the Multi-Ethnic Study of Atherosclerosis (MESA).  Arch Intern Med. 2008;  168 1333-1339
  • 23 Detrano R, Guerci A D, Carr J J. et al . Coronary calcium as a predictor of coronary events in four racial or ethnic groups.  N Engl J Med. 2008;  358 1336-1345
  • 24 Ostrom M P, Gopal A, Ahmadi N. et al . Mortality incidence and the severity of coronary atherosclerosis assessed by computed tomography angiography.  J Am Coll Cardiol. 2008;  52 1335-1343

Prof. Dr. med. Thorsten Dill

Abteilung Kardiologie
Kerckhoff-Klinik

Benekestr. 2 – 8
61231 Bad Nauheim

Email: t.dill@Kerckhoff-Klinik.de

    >