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Rationale CT-Bildgebung in der Kardiologie

Rational CT imaging in cardiology

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Zusammenfassung

Aufgrund technischer Weiterentwicklungen wächst der Stellenwert der Computertomographie (CT) in der kardiologischen Diagnostik. Die CT wird dabei insbesondere für die Diagnose der koronaren Herzkrankheit (KHK), seltener für spezielle Fragestellungen wie Koronaranomalien und die Beurteilung der Herzklappen oder der Herzfunktion eingesetzt. Aufgrund der Strahlenexposition sollte die Indikation für eine Herz-CT insbesondere bei Kindern und Frauen jedoch streng gestellt werden. So kann beispielsweise eine Koronarkalkbestimmung bei einem asymptomatischen Patienten mit intermediärem Risiko für die genauere Risikoabschätzung hilfreich sein. Eine koronare CT-Angiographie kann bei einem Patienten mit thorakalen Schmerzen und intermediärem Risikoprofil zur Beurteilung hinsichtlich einer stenosierenden KHK eingesetzt werden. Andere Patienten, beispielsweise symptomatische Patienten mit hohem kardiovaskulärem Risiko, sollten dagegen keiner CT unterzogen werden, da hier häufig ohnehin eine invasive Abklärung notwendig wird. Somit ist für einen sinnvollen Einsatz der CT in der Kardiologie insbesondere eine differenzierte Indikationsstellung notwendig.

Abstract

Due to continuous technical developments computed tomography (CT) is increasingly being used for cardiac diagnostics, especially for diagnosis of coronary artery disease (CAD) or less commonly for evaluation of coronary artery anomalies, cardiac valves or cardiac function. Because CT exposes patients to ionizing radiation it should only be performed in patients with a clear indication. Calcium scoring for example may improve risk stratification in asymptomatic patients with an intermediate risk profile or coronary CT angiography may be used to exclude or confirm obstructive CAD in symptomatic patients at intermediate cardiovascular risk. However, other patients, such as symptomatic patients with high cardiovascular risk should not be examined using CT. Therefore, a reasonable use of CT in cardiology requires a differentiated selection of patients.

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  1. Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland

    B. Bischoff

  2. Medizinische Klinik und Poliklinik I, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland

    J. Hausleiter

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  1. B. Bischoff
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Correspondence to B. Bischoff.

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Bischoff, B., Hausleiter, J. Rationale CT-Bildgebung in der Kardiologie. Internist 54, 810–817 (2013). https://doi.org/10.1007/s00108-012-3238-8

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  • DOI: https://doi.org/10.1007/s00108-012-3238-8

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