光子计数CT在老年冠心病中的应用

doi:10.3969/j.issn.1003-9198.2025.12.001

摘要/Abstract

摘要： 冠心病是导致我国老年人群残疾与死亡的首要病因。冠状动脉CT血管成像(coronary computed tomography angiography,CCTA)是评估冠状动脉粥样硬化的重要影像学手段之一,但老年人冠状动脉病变常表现为多支血管弥漫性病变、严重钙化负荷及易损斑块识别困难,加之对比剂肾毒性风险高,以及冠状动脉支架、心脏起搏器植入等较为常见,限制了传统能量积分探测器CCTA在该人群中的应用。光子计数CT(photon-counting computed tomography, PCCT)是近十年来CT成像领域的重要突破,特别是其超高空间分辨率对冠状动脉硬化斑块评估能力有明显的提升,为应对上述临床挑战提供了新的技术路径。本文系统综述PCCT的关键技术特点,探讨其在老年冠心病精准诊疗中的应用价值,并对未来研究方向提出展望,以推动该技术更好地服务于老年冠心病的诊疗管理。

关键词: 光子计数CT, 冠状动脉CT血管成像, 冠状动脉疾病

Abstract: Coronary atherosclerotic heart disease is the leading cause of disability and death among the elderly adults in China. Coronary computed tomography angiography (CCTA) is an important imaging technique for evaluating coronary atherosclerotic plaques. However, in elderly patients, coronary lesions often present as diffuse multi-vessel diseases, severe calcification burden, and vulnerable plaques that are difficult to identify. Additionally, elderly patients are more susceptible to contrast-induced nephrotoxicity, and the higher prevalence of coronary stents and cardiac pacemakers limit the application of conventional energy-integrating detector-based CCTA in this population. Photon-counting computed tomography (PCCT) represents a major breakthrough in CT imaging over the past decade. Its ultra-high spatial resolution significantly improves the assessment of coronary atherosclerotic plaques, offering a new technological approach to address the aforementioned clinical challenges. This article provides a systematic review of the key technical features of PCCT, discusses its application value in the precise diagnosis and treatment of coronary heart disease in the elderly, and offers insights into future research directions, aiming to promote the better application of PCCT in the diagnosis and management of coronary heart disease in the elderly.

Key words: photon-counting CT, coronary computed tomography angiography, coronary artery disease

中图分类号:

R 541.4

胡秋菊, 罗松. 光子计数CT在老年冠心病中的应用[J]. 实用老年医学, 2025, 39(12): 1189-1194.

HU Qiuju, LUO Song. Application of photon-counting CT in elderly patients with coronary artery disease[J]. Practical Geriatrics, 2025, 39(12): 1189-1194.

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