medicina50巻6号

2013年06月発行

特集 最新の動脈硬化診療―どう診断し，どう治療するか？ 画像診断と機能検査の位置づけ

冠動脈CT

著者： 山本秀也¹ 木原康樹¹

所属機関： ¹広島大学大学院循環器内科学

ページ範囲：P.1014 - P.1018

ポイント

◎冠動脈CTAは良好な冠動脈狭窄検出能を有している．

◎検出不能例については心筋血流評価を併用することでその有用性の向上が期待される．

参考文献

1）Miller JM, et al：Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med 359：2234-2236, 2008

2）Budoff MJ, 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 52：1724-1732, 2008

3）日本循環器学会，他（編）：冠動脈病変の非侵襲的診断法に関するガイドライン．Circ J 73：1019-1089, 2009

4）Einstein AJ, et al：Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 298：317-323, 2007

5）Greenland P, et al：ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain；A report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force（ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography）．J Am Coll Cardiol 115：378-402, 2007

6）Nasir K, Clouse M：Role of nonenhanced multidetector CT coronary artery calcium testing in asymptomatic and symptomatic individuals1. Radiology 264：637-649, 2012

7）Raff GL, et al：SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography. J Cardiovasc Comput Tomogr 3：122-136, 2009

8）Narula J, et al：Histopathologic characteristics of atherosclerotic coronary disease and implications of the findings for the invasive and noninvasive detection of vulnerable plaques. J Am Coll Cardiol 61：1041-1051, 2013

9）Min JK, et al：Age and sex-related differences in all-cause mortality risk based on coronary computed tomography findings；Results from the international multicenter CONFIRM（coronary CTA angiography evaluation for clinical outcomes；An international multicenter registry）of 23,854 patients without known coronary artery disease. J Am Coll Cardiol 58：849-860, 2011

10）Min JK, et al：Diagnostic accuracy of fractional flow reserve from anatomic CT Angiography. JAMA 308：1237-1245, 2012