光子计数CT心脏成像：多机构技术原理、临床证据与实践协议指南
该多机构指南总结了光子计数探测器CT（PCD-CT）在心脏成像中的技术原理与临床应用证据，涵盖CCTA协议选择、支架与钙化斑块评估、CT-FFR、结构性心脏病术前规划及心肌组织表征，并提供标准化扫描模式与重建参数的实用路径。
要点
- PCD-CT凭借直接能量甄别与超高空间分辨率，可改善冠状动脉管腔显示。
- 指南覆盖支架、重度钙化斑块、CT-FFR、TAVR规划及心肌延迟强化等场景。
- 提供标准化扫描模式、重建核、迭代重建等级与光谱输出的协议表格。
英文原文（摘要）· 点击展开
Coronary CT angiography (CCTA) is recommended as a first-line test for evaluating suspected coronary artery disease in many patient cohorts. Photon-counting detector CT (PCD-CT) introduces direct energy discrimination, higher geometric dose efficiency, and ultrahigh spatial resolution compared to energy-integrating detector CT, enabling improved coronary lumen visualization and intrinsic spectral imaging. This multi-institutional guidance summarizes technical principles of PCD-CT relevant to cardiac imaging and synthesizes contemporary evidence across key applications: (1) CCTA protocol selection and reconstruction (including ultrahigh-resolution modes); (2) stent and heavily calcified plaque assessment; (3) coronary physiology using CT-derived fractional flow reserve; (4) structural heart evaluation including pre-TAVR planning; and (5) myocardial tissue characterization with late enhancement and extracellular volume mapping. We provide pragmatic protocol pathways and contrast-dose strategies, with compact tables that standardize scan modes, reconstruction kernels, iterative reconstruction levels, and spectral outputs.
引用
- Hagar MT, Vecsey-Nagy M, Kravchenko D, et al. Photon-counting CT in cardiac imaging: multi-institutional guidance on technical principles, clinical evidence, and practical protocols. Eur J Radiol. 2026. PMID: 42114381. doi:10.1016/j.ejrad.2026.112904
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。