Tom 19, Nr 3-4 (2024)
Inne materiały uzgodnione z Redakcją
Opublikowany online: 2025-03-27
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Tomografia komputerowa w diagnostyce choroby wieńcowej: aktualna pozycja w wytycznych i nowe możliwości diagnostyczne
Kardiol Inwazyjna 2024;19(3-4):66-73.
Streszczenie
Angiografia tętnic wieńcowych metodą tomografii komputerowej (CCTA, coronary computed tomography angiography) to ważne narzędzie diagnostyczne w chorobie wieńcowej, łączące wysoką rozdzielczość obrazu z minimalną inwazyjnością. Badanie pozwala na ocenę anatomiczną tętnic wieńcowych, analizę blaszek miażdżycowych oraz planowanie zabiegów rewaskularyzacji. Ograniczenia obejmują narażenie na promieniowanie rentgenowskie oraz konieczność podania środka kontrastowego, co jest szczególnie problematyczne u pacjentów z niewydolnością nerek. Postęp technologiczny umożliwił redukcję dawki promieniowania i skrócenie czasu badania. Wytyczne Europejskiego Towarzystwa Kardiologicznego (ESC, European Society Of Cardiology) 2024 wskazują CCTA jako badanie pierwszego wyboru u pacjentów z niskim do umiarkowanym ryzykiem choroby wieńcowej (CAD, coronary artery disease) oraz w przypadkach, gdy inne metody diagnostyczne są niejednoznaczne. Wprowadzenie CT-FFR (computed tomography-derived fractional flow reserve), jako uzupełnienia klasycznej CCTA, może w przyszłości pozwolić na czynnościową ocenę istotności zwężeń nasierdziowych w sposób bezinwazyjny.
Słowa kluczowe: tomografia komputerowaangio-CTwskaźnik zwapnienia tętnic wieńcowychprzewlekłe zespoły wieńcowediagnostyka nieinwazyjna
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