Kardio-CT und Kardio-MR - konkurrierend oder komplementär zur Nuklearkardiologie?

Zusammenfassung

Zusammenfassend kann festgestellt werden, dass es sich bei Kardio-CT und Kardio-MR um zwei technisch unterschiedliche Schnittbildverfahren handelt, die in der Kardiologie eine ständig wachsende Bedeutung gewinnen. Die Anwendungsschwerpunkte beider Verfahren unterscheiden sich derzeit trotz der Ähnlichkeit der Abbildung grundsätzlich. Der Schwerpunkt der klinischen Anwendungen des Kardio-CTs konzentriert sich auf die nicht-invasive Darstellung von Koronararterien. Diesbezüglich ist das Kardio-CT dem Kardio-MR aufgrund der höheren Ortsauflösung derzeit überlegen. Der Schwerpunkt klinischer Anwendungen der Kernspintomographie liegt derzeit neben der morphologischen Darstellung des Herzens bei intra- und perikardialen Tumoren, komplexen Vitien und Pathologie der großen Gefäße vor allem in der Beurteilung von Störungen der Ventrikelfunktion (Dobutamin-Stressecho) und der Perfusion (Adenosin) unter Belastung, sowie in zunehmendem Maße in der Beurteilung der Ausdehnung und Lokalisation von Myokarddefekten, wie sie im Rahmen von Infarkten, aber auch von Myokarditiden auftreten können. Bei diesen Anwendungsmöglichkeiten tritt die Kernspintomographie nur mit einem Teil in direkte Konkurrenz zur nuklearkardiologischen Diagnostik. Mit den Vorteilen einer fehlenden Exposition von radioaktiver Strahlung sowie einer höheren Ortsauflösung ersetzt das Kardio-NMR in diesen Anwendungsbereichen allerdings heute in zunehmendem Umfang die nuklearkardiologische Diagnostik des Herzens.

Abstract

In summary, cardiac computed tomography (CT) and cardiac magnetic resonance (MR) are two different technologies with distinct imaging properties that gain increasing importance in clinical cardiology. Even though images may look similar, the areas of application of CT and MR are quite different. Clinical applications of cardiac CT focus on on-invasive imaging of the coronary arteries. In this respect, the higher spatial resolution of cardiac CT constitutes a significant advantage as compared to MR and clinical results are superior. Clinical applications of cardiac MR, next to morphologic imaging of the heart, are most frequently found in the context of intra-and pericardial masses, complex congenital anomalies, and the assessment of left ventricular function (dobutamine) and perfusion (adenosine) under stress. The evaluation of the size and localization of myocardial necrosis, scars, and fibrosis gains increasing importance, for example in the workup of myocardial infarction, but also myocarditis and cardiomyopathies. In this respect, magnetic resonance imaging partly constitutes an alternative to nuclear medicine methods. Due to the lack of ionizing radiation and a relatively high spatial resolution, an increase of MR diagnostic procedures at the expense of nuclear medicine can be expected.

Kardio-CT - Kardio-NMR - Myokardperfusion - kardiale Bildgebung - koronare Herzerkrankung

Cardiac CT - cardiac NMR - myocardial perfusion - cardiac imaging - coronary artery disease

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