ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document:心臓CT血管造影・心臓MR血管造影

CT血管造影、MR血管造影に関する”ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 Expert Consensus ”

CT血管造影は通常の血管造影と同等以上の被爆であることに改めて驚く！

CT血管造影

ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 Expert Consensus Document on Coronary Computed Tomographic Angiography: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents
http://content.onlinejacc.org/cgi/content/short/55/23/2663?rss=1
http://bit.ly/cv1V4B

MR血管造影

ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents
http://content.onlinejacc.org/cgi/content/short/55/23/2614?rss=1
http://bit.ly/cYkoe2

じっくり読まないといけないが、放射線被ばくに関して改めて驚く
（参照：http://content.onlinejacc.org/cgi/content/full/55/23/2663/TBL4）
胸部レントゲンPA+側面では、”Representative Effective Dose Value (mSv)　０．１　、Range of Reported Effective Dose Values (mSv)　０．０５－０．２４”だが、６４スライス冠動脈CTAでは、modulation改善前　１５、１２－１８、改善後でも９、８－１８で、通常の肝動脈造影で、７、２ー１６であるのを考えれば、改善されているとはいえ、放射線被ばくに関してCT血管造影は通常の血管造影と同等以上の被爆であることに留意すべきであろう。

1 Ordering coronary CTA only in keeping with established appropriateness criteria for cardiac CT and CMR (1), and only if the clinical question at hand cannot be adequately addressed by other means (an update of appropriate use criteria for cardiac CT is expected in 2010 and an update of appropriate use criteria for CMR is planned).
2 Performing the CTA study with the minimum radiation dose required for adequate diagnostic quality.
3 Avoiding unnecessarily repeating coronary CTA.

検診のごとき冠動脈造影CT施行らしき文面が医療機関ウェブでもみられるが、これらの乱用は厳格に慎まなければならない！

なんらかのregulationが必要と思う。