循環器ジャーナル67巻4号

2019年10月発行

特集 冠動脈疾患のリスク管理のフロントライン Ⅰ．冠動脈疾患イベントリスクをどう評価する？

CTでどう評価する？

著者： 中村日出彦¹ 石川哲也¹ 田口功¹

所属機関： ¹獨協医科大学埼玉医療センター循環器内科

ページ範囲：P.546 - P.553

Point
・冠動脈CTは目覚ましい進化を遂げ，冠動脈疾患の診断ツールとして確立されており，その高い陰性適中率からスクリーニングに最適の検査である．
・冠動脈CTのプラーク評価については様々な報告が散見されており，今後ACSの予測因子などに有用となることが期待される．
・FFR-CTを始めとした冠動脈の機能的評価における診断能も期待される．

参考文献

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4) Budoff MJ, Dowe D, Jolis JG, 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

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11) Koo BK, Erglis A, Doh JH, et al:Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW（Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve）study. J AM Coll Cardiol 58:1989-1997, 2011

12) Douglas PS, Pontone G, Hlatky MA, et al:PLATFORM Investigators:Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. usual care in patients with suspected coronary artery disease:the prospective longitudinal trial of FFR（CT）:outcome and resource impacts study. Eur heart J 36:3359-3367, 2015

13) 日本循環器学会：FFRCTの適正使用指針．2016　http://www.j-circ.or.jp/topics/FFRCT_tekisei_shishin_h301201.pdf

14) 長尾充展：心筋CTストレインと冠動脈フローマップで迫る4次元病態解析．JRC 2018 ziosoft/AMIN seminar Report New Horizon of 4D Imaging