CT Scan’s Look Inside the Heart - rbk.de · Coronary Calcium Measurement: CT-Scanner Type -...
Transcript of CT Scan’s Look Inside the Heart - rbk.de · Coronary Calcium Measurement: CT-Scanner Type -...
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CT Scan’s Look Inside the Heart
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Coronary artery calcification - KHKCAC-Scores - Untersuchungsmethoden
Budoff Circulation 2006
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Coronary artery calcificationCAC-Scores
0 = none
1 - 400 = mild to moderate
401- 1000 = severe
> 1000 = very severe
modifizierter Rumberger-Score Mayo Clin Proc 1999
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Computertomografie - Technik
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Electron Beam CT - Technik
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Herz-CT: Technik
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Herz-CT: Technik
Alkadhi Herz CT Buch
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Herz-CT: Technik
Alkadhi Herz CT Buch
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Dual source CT
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Coronary artery calcificationCAC-Scores
Chertow et al. Kidney Int. 2002;62:245-252 (TTG)
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Coronary artery calcificationCAC-Scores
Chertow et al. Kidney Int. 2002;62:245-252 (TTG)
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Comparison of Agatston and volume score
• Agatston score — Obtained by multiplying the calcium area by a number related to
density (‘density factor’) — Interscan variability: 8 to 10%
• Volume score — Using additional interpolated slices providing higher resolution — Interscan variability: 6 to 8%
Calcified plaque area=A; density=D
Vessel lumen
Chertow et al. Kidney Int. 2002;62:245-252 (TTG) Budoff et a. Circulation 2006;114
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Coronary Calcium Measurement: Scoring System
Detrano CD Radiology 2005
Mean Relative Rescan Differences and Reproducibility Coefficients for Each Scanner Type according to Calcium Measure
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Coronary Calcium Measurement: CT-Scanner Type
Detrano CD Radiology 2005
Transverse electron-beam (top) and multi–detector row (Lightspeed Plus) (bottom) CT scans show typical images of heart and of calibration phantom placed appropriately below thorax. Arrows indicate four cylindrical bars containing known concentrations of hydroxyapatite (0, 50, 100 and 200 mg/mL). Image attenuation was adjusted by comparing measured attenuation in bars with predetermined attenuations corresponding to known densities of hydroxyapatite.
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Coronary Calcium Measurement: CT-Scanner Type
Detrano CD Radiology 2005
Comparison of Mean Absolute Rescan Differences for Calcium Measures according to Scanner Type and Agatston Score
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Coronary Calcium Measurement: CT-Scanner Type - Scoring System
Detrano CD Radiology 2005
Scatter diagrams show rescan difference plotted against (a) Agatston
score, (b) calcium volume, and (c) interpolated volume score for both scans. Rescan differences increase
with extent of calcium and are comparable for all three calcium
measures. Lines on each diagram show limits of reproducibility and indicate boundaries within which rescan differences fall 95% of the
time. Corresponding reproducibility coefficients are 0.226, 0.224, and 0.209 for Agatston score, calcium volume, and interpolated volume
score, respectively.
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CT - Strahlendosis
Untersuchung Strahlendosis (mSv) Faktor xRö-Thorax 0,02
natürliche Strahlung 2,1 105CCT 1,5 - 1,7 85
Mammographie 3 150CT-Abdomen 5,3 - 10 500
CT-Thorax 5,8 - 8 400CT-Thorax - Becken 9,9 500
Transatlantikflug 0,1 51 Zigarette 0,07 3,5Herz-CT 12 600
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Welche Bildgebung ?
3.3.1. Bei Patienten in den Stadien 3-5D einer chronischen Nierenerkrankung schlagen wir vor, dass eine konventionelle laterale Abdomen-Röntgenaufnahme zum Nachweis oder A u s s c h l u s s v o n G e f ä ß v e r k a l k u n g e n s o w i e e i n e Echokardiographie zum Nachweis oder Ausschluss von Herzklappenverkalkungen als sinnvolle Alternativen zur CT-basierten Bildgebung eingesetzt werden können (2C) .
3.3.2. Wir schlagen vor, dass Patienten in den Stadien 3-5D einer chronischen Nierenerkrankung mit nachgewiesenen Gefäß- bzw. Herzklappenverkalkungen als kardiovaskuläre Hochrisikopatienten betrachtet werden (2A) . Es erscheint sinnvoll, diese Information im Therapiemanagement von Störungen des Knochen- und Mineralstoffwechsels zu berücksichtigen (ohne Graduierung) .
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Welche Bildgebung ?
3.3.1. Bei Patienten in den Stadien 3-5D einer chronischen Nierenerkrankung schlagen wir vor, dass eine konventionelle laterale Abdomen-Röntgenaufnahme zum Nachweis oder A u s s c h l u s s v o n G e f ä ß v e r k a l k u n g e n s o w i e e i n e Echokardiographie zum Nachweis oder Ausschluss von Herzklappenverkalkungen als sinnvolle Alternativen zur CT-basierten Bildgebung eingesetzt werden können (2C) .
3.3.2. Wir schlagen vor, dass Patienten in den Stadien 3-5D einer chronischen Nierenerkrankung mit nachgewiesenen Gefäß- bzw. Herzklappenverkalkungen als kardiovaskuläre Hochrisikopatienten betrachtet werden (2A) . Es erscheint sinnvoll, diese Information im Therapiemanagement von Störungen des Knochen- und Mineralstoffwechsels zu berücksichtigen (ohne Graduierung) .
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Welche Bildgebung ?
3.3.1. Bei Patienten in den Stadien 3-5D einer chronischen Nierenerkrankung schlagen wir vor, dass eine konventionelle laterale Abdomen-Röntgenaufnahme zum Nachweis oder A u s s c h l u s s v o n G e f ä ß v e r k a l k u n g e n s o w i e e i n e Echokardiographie zum Nachweis oder Ausschluss von Herzklappenverkalkungen als sinnvolle Alternativen zur CT-basierten Bildgebung eingesetzt werden können (2C) .
3.3.2. Wir schlagen vor, dass Patienten in den Stadien 3-5D einer chronischen Nierenerkrankung mit nachgewiesenen Gefäß- bzw. Herzklappenverkalkungen als kardiovaskuläre Hochrisikopatienten betrachtet werden (2A) . Es erscheint sinnvoll, diese Information im Therapiemanagement von Störungen des Knochen- und Mineralstoffwechsels zu berücksichtigen (ohne Graduierung) .
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Konventionelles Röntgen
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Echokardiographie
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Echokardiographie
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Echokardiographie
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Echokardiographie