Roles of    Nuclear Cardiology,    Cardiac Computed Tomography   Cardiac Magnetic Resonance:  Assessment of Patients with ...
Role of CT Coronary Angiography(CTA) <ul><li>spatial resolution of 0.4 mm </li></ul><ul><li>high sensitivity and high spec...
 
 
CTA  and  myocadiac perfusion SPECT <ul><li>For intermediate risk patients </li></ul><ul><li>CTA-preferred initial test </...
 
 
Limitation of coronary CTA <ul><li>presence of dense calcification of the coronary arteries </li></ul><ul><li>need for a r...
PET/CT and SPECT/CT <ul><li>provide both detection of coronary stenosis and assessment of functional significance </li></u...
Role of CMR in Detection of CAD <ul><li>effective method for comprehensive cardiac assessment </li></ul><ul><li>assessment...
<ul><li>ischemic or nonischemic cardiomyopathy </li></ul><ul><li>high resolution of CMR allows the discrimination of suben...
 
Role of CMR in Detection of CAD <ul><li>No radiation, no contrast </li></ul><ul><li>Extended study time, needed expertise ...
Conclusion <ul><li>CT and CMR techniques are currently undergoing rapid technological development and growth </li></ul><ul...
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Nuclear Cardiology(2) . . . æ±Ÿå¿ ç©Ž

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Nuclear Cardiology(2) . . . æ±Ÿå¿ ç©Ž

  1. 1. Roles of Nuclear Cardiology, Cardiac Computed Tomography Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease INT 江忠穎
  2. 2. Role of CT Coronary Angiography(CTA) <ul><li>spatial resolution of 0.4 mm </li></ul><ul><li>high sensitivity and high specificity </li></ul><ul><li>fewer heart beats are required for acquisition </li></ul><ul><li>low-contrast dose ,<100 mL are routine </li></ul><ul><li>be performed in approximately 10 min </li></ul><ul><li>can visualize not only the vessel lumen but also the wall </li></ul><ul><li>the size of noncalcified coronary plaque </li></ul><ul><li>pulmonary embolism,acute coronary syndrome, and aortic dissection </li></ul>Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med. Jan 01, 2006
  3. 5. CTA and myocadiac perfusion SPECT <ul><li>For intermediate risk patients </li></ul><ul><li>CTA-preferred initial test </li></ul><ul><li>MPS-seondary test </li></ul><ul><li>For purposes of risk assessment, for patients with known disease or for those known or likely to have extensive coronary calcium, MPS is likely to remain as the dominant approach. </li></ul>Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med. Jan 01, 2006
  4. 8. Limitation of coronary CTA <ul><li>presence of dense calcification of the coronary arteries </li></ul><ul><li>need for a regular heart rhythm and a relatively low heart rate </li></ul><ul><li>a tendency to overestimate the degree of stenosis </li></ul><ul><li>radiation </li></ul>Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med. Jan 01, 2006
  5. 9. PET/CT and SPECT/CT <ul><li>provide both detection of coronary stenosis and assessment of functional significance </li></ul><ul><li>Provide information with regard to coronary calcium, coronary stenoses, and stress-induced ischemia. </li></ul>Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med. Jan 01, 2006
  6. 10. Role of CMR in Detection of CAD <ul><li>effective method for comprehensive cardiac assessment </li></ul><ul><li>assessment of cardiac chamber volumes and function </li></ul><ul><li>myocardial mass and thrombi </li></ul><ul><li>valvular function </li></ul><ul><li>high resolution </li></ul><ul><li>complex congenital and acquired cardiac and vascular disease </li></ul><ul><li>Late enhancement with gadolinium-detect MI, both acute and chronic </li></ul>Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med. Jan 01, 2006
  7. 11. <ul><li>ischemic or nonischemic cardiomyopathy </li></ul><ul><li>high resolution of CMR allows the discrimination of subendocardial and subepicardial flow </li></ul><ul><li>In comparison to MPS, the advantage of CMR is the lack of dependence on regional hypoperfusion </li></ul><ul><li>The limitation of balanced reduction of flow is unlikely to apply to CMR </li></ul>Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med. Jan 01, 2006
  8. 13. Role of CMR in Detection of CAD <ul><li>No radiation, no contrast </li></ul><ul><li>Extended study time, needed expertise </li></ul><ul><li>Acquisitions are obtained over several heart beats, increasing the possibility of misregistration </li></ul><ul><li>a meta-analysis of 48 studies in which MSCT has </li></ul><ul><li>been shown to have higher sensitivity and specificity than CMR for noninvasive coronary angiography </li></ul>Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med. Jan 01, 2006
  9. 14. Conclusion <ul><li>CT and CMR techniques are currently undergoing rapid technological development and growth </li></ul><ul><li>nuclear cardiology techniques will continue to be of great practical value and will often be used in combination with the CCT or CMR modalities. </li></ul>Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med. Jan 01, 2006
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