影像学1循环.ppt

* * * * * * * * * * * * --------- Ross 1999; Encyclopedia of Medical Images Endothelial dysfunction Fatty streak Fibrofatty lesion Fibrous plaque CTA with diagnosis------CAD LV LA RV RA Ao. PV LM signs ↑ ↑ Findings of plain film Coronary Heart Disease(CHD) Coronary Heart Disease(CHD) Case1 of CAD Case1 of CAD A possibility of coronary CT is that the technique can assess the presence of occult atherosclerosis and might develop as a useful tool to screen for early detection of atherosclerosis in asymptomatic subjects. Because CT coronary imaging comprehensively evaluates the composition (calcific and noncalcific) of coronary plaques, it might provide prognostic evidence independent of and incremental to simple CT calcium scoring. Pim J. de Feyter, Carl J. Schultz. Tomography Coronary Angiography for Screening Asymptomatic Subjects,Journal of the American College of Cardiology 2008;52:366–8 Because approximately 50% of all acute coronary syndromes occur in previously asymptomatic subjects, there obviously is a need to identify these subjects before coronary atherosclerosis becomes clinically manifest and irreversible damage occurs by progression to myocardial infarction or cardiac death Murabito JM, Evans JC, Larson MG, Levy D. Prognosis after the onset of coronary heart disease. An investigation of differences in outcome between the sexes according to initial coronary disease presentation. Circulation 1993;88:2548 –55. Theory and preparement of CTA Follow-up of CTA Diagnosis of CTA Application of triple rule-out with 256-slice spiral CT in the diagnosis of acute chest pain Case1 of aortic dissection—follow-up 2009.10.9 2009.9.16 Case1 of aortic dissection—follow-up 2009.10.9 2009.9.16 Case2 of aortic dissection—follow-up 2009.11.5 2009.9.27 Case2 of aortic dissection—follow-up 2009.11.5 2009.9.27 The research we are doing now 2009.11.5 2009.9.27 Radiation dose CTDIvol* Scan Length*0.014 13.9mGy* 56.75*0.014=11mSv Radiation dose CTDIvol* Scan Length*0.014 5