Advancing the diagnostic frontier of cardiovascular diseases with MDCT

• Main Authors: I-Chen Tsai, 蔡依橙
• Other Authors: Yun-Ching Fu
• Format: Others
• Language: en_US
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/90256718529176704084

博士 === 國立陽明大學 === 臨床醫學研究所 === 99 === The rapid advancement of multi-detector row computed tomography (MDCT) has provided new clinical pathways in diagnosing cardiovascular diseases. We used the 40-, 64- and 256-MDCT in our hospital to further advance the diagnostic frontier of cardiovascular disease in four major aspects, including congenital heart disease, comprehensive whole-heart evaluation, intracardiac prosthesis and vascular CT. About congenital heart disease, we first confirmed the diagnostic accuracy of MDCT in complex congenital heart disease is 98%. Then the visibility of proximal coronary arteries is found to be 100%. The associated techniques and interpretation algorithm were summarized and published. Regarding comprehensive whole-heart evaluation, we first confirmed our scanner has a 97.9% accuracy in diagnosing coronary artery stenosis. With the evaluation of heart motion and viability, we proposed 'comprehensive whole-heart approach' in cardiac CT and diagnosed many different cardiac diseases in clinical practice. After the concept is widely accepted in academic society, we further worked with Asian experts to summarize a guideline article promoting the use of cardiac CT. Considering intracardiac prosthesis, we confirmed the accuracy of MDCT in diagnosing prosthetic valve disorder is 100%. The diagnostic skill was also applied to Amplatzer septal occluder. About vascular CT, we first developed our own novel and reproducible contrast injection skill: 'contrast-covering time' and used it to diagnose many vascular diseases. The clinical experiences in patients with suspected renal hypertension and dialysis arteriovenous fistula were also summarized and published. In conclusion, with our efforts, MDCT is confirmed to be a new diagnostic tool in cardiovascular diseases.