Diagnostik der koronaren Herzkrankheit mit CT und MRT

Zusammenfassung

Die sozioökonomische Bedeutung der koronaren Herzkrankheit und der Wunsch nach nichtinvasiver Diagnostik möglichst ohne ionisierende Strahlen sind Motive für kardiale Anwendungen der CT und MRT. Noch vor wenigen Jahren war eine Koronarangiographie mit der CT undenkbar, heute ist sie bei ausgewählten Fragestellungen bereits Routine. Die MRT ist Referenzstandard für zahlreiche Funktionsparameter wie Pumpfunktion, Auswurffraktion, Ventrikelvolumina und Schlagvolumen. Die Vitalität des Herzmuskels wird mit höchster Ortsauflösung zuverlässig beurteilt. Die Perfusionsuntersuchung ist ebenfalls mit der MRT möglich, muss allerdings noch validiert werden.

Dieser Artikel gibt eine Übersicht über klinische Fragestellungen, gegenwärtige und zukünftige Anwendungen sowie Grenzen der kardialen CT und MRT bei der Diagnostik der koronaren Herzkrankheit.

Abstract

The socioeconomic importance of coronary artery disease and the desire for noninvasive imaging with less or no ionizing radiation are incentives for computed tomography (CT) and magnetic resonance imaging (MRI) of the heart. Coronary arteriography with CT is now routine for selected clinical questions. MRI is the gold standard for analyzing several functional parameters, such as pump function, ejection fraction, ventricular volumes and stroke volumes. It is a robust tool for imaging myocardial viability at high spatial resolution. Moreover, perfusion imaging with MRI is possible, but still requires validation in larger series. This article reviews clinical applications, limitations and future aspects of cardiac CT and MRI in the diagnosis of coronary artery disease.

Key Words

Coronary artery disease - Computed tomography - Magnetic resonance imaging

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