循環器臨床を変えるMDCT

出版社: 文光堂
著者:
発行日: 2015-04-04
分野: 臨床医学:内科  >  循環器一般
ISBN: 9784830619243
電子書籍版: 2015-04-04 (第1版第2刷)
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非造影MDCTで心臓を撮るだけでも多くの重要な情報を得ることができますが,その事実は意外と知られていません.例えば,冠動脈石灰化は非造影MDCTから自動的に定量化できる指標です.動脈硬化のプロセスでしかできないものであるため,石灰化スコアを用いることにより患者のリスク層別化が可能となります.造影MDCTは冠動脈疾患の評価のみならず,心臓弁膜症や先天性心疾患における解剖の把握に必須の検査となっています.

目次

  • 循環器臨床を変えるMDCT

    ―目次―

    I 循環器臨床の常識を変えたMDCT
     1. 循環器臨床の常識を変えたMDCT─そのコンセプトと活用法─

    II 造影剤を使わなくてもここまでわかる!
     1. 冠動脈石灰化を臨床にどう活かす?
     2. 最近注目されている心膜脂肪
     3. 心筋の脂肪変性を評価する
     4. 非造影MDCTで見逃してはならない他臓器の病変

    III 造影心臓CTで冠動脈を評価する
     1. 正常冠動脈はCTでどうみえる?
     2. 見逃してはならない冠動脈走行異常
     3. 冠動脈狭窄を評価する
     4. 冠動脈閉塞を評価する
     5. 冠動脈プラークを評価する

    IV 心臓を評価する
     1. 心筋を観察する
     2. 心機能を評価する
     3. 心臓弁膜を評価する
     4. 異常構造物を評価する
     5. カテーテルアブレーションに活かす
     6. 成人先天性心疾患で活かす
     7. 心膜,心?液を診断し治療に活かす

    V 肺動脈血栓塞栓症を評価する
     1. 肺動脈血栓塞栓症を診断する
     2. バルーン肺動脈形成術に活かす肺動脈CT

    VI 救急外来で行う心臓CT
     1. triple-rule-out─どうする? どう解釈する?─
     2. 急性冠症候群はCTで診断できるか

    VII 心臓CTを理解するために
     1. MDCTの基本原理を知っておこう!
     2. 心臓CTを成功させるために必要なこと

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I 循環器臨床の常識を変えたMDCT

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II 造影剤を使わなくてもここまでわかる !

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IV 心臓を評価する

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V 肺動脈血栓塞栓症を評価する

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5) Castaner, E et al : CT diagnosis of chronic pulmonary thromboembolism. Radiographics 2009 ; 29 : 31-50 ; discussion 50-53

VI 救急外来で行う心臓CT

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2) Goldstein, JA et al : A randomized controlled trial of multi-slice coronary computed tomography for evaluation of acute chest pain. J Am Coll Cardiol 2007 ; 49 : 863-871
3) Hoffmann, U et al : Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med 2012 ; 367 : 299-308
4) Hulten, E et al : Outcomes after coronary computed tomography angiography in the emergency department : a systematic review and meta-analysis of randomized, controlled trials. J Am Coll Cardiol 2013 ; 61 : 880-892
5) Motoyama, S et al : Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol 2009 ; 54 : 49-57
6) Cademartiri, F et al : Influence of intracoronary attenuation on coronary plaque measurements using multislice computed tomography : observations in an ex vivo model of coronary computed tomography angiography. Eur Radiol 2005 ; 15 : 1426-1431

VII 心臓CTを理解するために

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4) Lell, M et al : Prospectively ECG- triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT : technique and initial experience. Eur Radiol 2009 ; 19 : 2576-2583
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6) Cigarroa, RG et al : Dosing of contrast material to prevent contrast nephropathy in patients with renal disease. Am J Med 1989 ; 86 : 649-652
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8) Brar, SS et al : Haemodynamic-guided fluid administration for the prevention of contrast-induced acute kidney injury : the POSEIDON randomized controlled trial. Lancet 2014 ; 383 : 1814-1823
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1) 佐野始也ほか : 320列面検出器CTを用いた前向き心電図同期冠動脈撮影の心拍数別撮影プロトコルにおける被ばくと画質の検討. 日放技学誌 2011 ; 67 : 1398-1407
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1) Abbara, S et al : SCCT guidelines for performance of coronary computed tomographic angiography : A report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr 2009 ; 3 : 190-204
2) 山口隆義 : CT値確保できたらこうなります-造影 理論と実践-. Innervision 2007 ; 22 : 10-14
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4) Jinzaki, M et al : ASCI 2010 contrast media guideline for cardiac imaging : a report of the Asian Society of Cardiovascular Imaging cardiac computed tomography and cardiac magnetic resonance imaging guideline working group. Int J Cardiovasc Imaging 2010 ; 26 : 203-212
5) 山口隆義ほか : 新しい造影方法であるtest bolus tracking法の開発と冠状動脈CT造影検査における有用性について. 日放技学誌 2009 ; 65 : 1032-1040
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1) Leipsic, J et al : SCCT guidelines for the interpretation and reporting of coronary CT angiography : a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr 2014 ; 8 : 342-358

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