RESUMO
Coronary artery disease (CAD) is the primary cause of death in adults in the United States. Only 50% of patients who present with a myocardial infarction have a prior history of CAD. Non-invasive cardiac imaging tests have been developed to diagnose CAD. Current guidelines and systematic reviews have tried to determine the prognostic value of the coronary artery calcium (CAC) scoring and the coronary computed tomography angiography (CCTA) for major adverse cardiovascular events. Several studies support the roles of CCTA and CAC scoring for the diagnosis of CAD in asymptomatic patients. Further studies are needed to confirm the superior role of CCTA over CAC scoring in symptomatic patients.
Assuntos
Calcinose/diagnóstico por imagem , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Medicina Baseada em Evidências , Programas de Rastreamento/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Calcinose/complicações , Doença da Artéria Coronariana/etiologia , Humanos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Pulmonary embolism is a major cause of worldwide morbidity and mortality. It is a common cause of cardiovascular care, second only to ischemic heart disease and cerebrovascular events, with a prevalence of 3 to 15%, and its diagnosis remains crucial in the early hours of symptom onset. Given its clinical variability, it has become a diagnostic challenge in the emergency rooms, thus a fast and accurate paraclinical evaluation is needed. The aim of the present manuscript is to review the current role of imaging methods, in particular multidetector computed tomography, their advantages and limitations and the imaging findings of acute or chronic pulmonary thromboembolism. Finally, diagnostic algorithms based on the Thoracic Fleischner Society and the group of PIOPED II study investigators, are shown.
Assuntos
Tomografia Computadorizada Multidetectores , Embolia Pulmonar/diagnóstico por imagem , Algoritmos , Angiografia/métodos , Humanos , Tomografia Computadorizada Multidetectores/efeitos adversos , Flebografia/métodos , Reprodutibilidade dos TestesRESUMO
El embolismo pulmonar es una importante causa de morbilidad y mortalidad en nuestro país y el mundo. Es una causa de atención médica cardiovascular frecuente, únicamente superada por la cardiopatía isquémica y los eventos vasculares cerebrales, con una prevalencia de 3% a 15%, siendo crucial su diagnóstico en las primeras horas de inicio de los síntomas. Dada la alta variabilidad en su presentación clínica, se ha convertido en un reto diagnóstico en las salas de urgencias, por lo que es indispensable contar con herramientas paraclínicas accesibles y rápidas para su diagnóstico. La presente revisión tiene como fin mostrar los métodos de imagen actuales, en particular a la tomografía computarizada multidetector, sus ventajas y limitaciones, así como los principales elementos de análisis para el diagnóstico de tromboembolismo pulmonar agudo y crónico. Asimismo, se mencionan algunos algoritmos de evaluación de acuerdo a la sociedad Fleischner del tórax y del grupo de investigadores del estudio PIOPED II, basados en la probabilidad pre-prueba del paciente y del resultado del dímero D.
Pulmonary embolism is a major cause of worldwide morbidity and mortality. It is a common cause of cardiovascular care, second only to ischemic heart disease and cerebrovascular events, with a prevalence of 3 to 15%, and its diagnosis remains crucial in the early hours of symptom onset. Given its clinical variability, it has become a diagnostic challenge in the emergency rooms, thus a fast and accurate paraclinical evaluation is needed. The aim of the present manuscript is to review the current role of imaging methods, in particular multidetector computed tomography, their advantages and limitations and the imaging findings of acute or chronic pulmonary thromboembolism. Finally, diagnostic algorithms based on the Thoracic Fleischner Society and the group of PIOPED II study investigators, are shown.
