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[EuroPCR 2012]联合无创影像学检查评估解剖结构和功能——瑞士Zurich大学医院Olivier Gämperli教授专访

作者:  O.Gämperli   日期:2012/5/29 9:34:23

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这取决于你更关注哪种检查,无创检查还是有创检查。在有创检查领域,当前最令人兴奋的技术之一就是光学相干成像。这一技术确实具有无与伦比的空间分辨率,可达到10 μm,这太了不起了。

  International Circulation: With the development of new techniques, there are many emerging clinical tools for coronary imaging. Please introduce some new coronary imaging methods which will be applied in clinic.
  Dr. Gämperli: It depends if you are looking more at the non-invasive or the invasive field. In the invasive field, there is one of the most exciting technologies in the field at the moment is OCT. It gives you really unparalleled spatial resolution down to 10micrometers, which is really fantastic. You can now visualize details of the plaque which before were impossible to see with conventional methods. You can see the size of the lipid core, a thin fibrous cap, a small dissection of thrombis material. After PCI, you can see stent deployment. You can assess age dissection. For me this is one of the most exciting development in the invasive field.
  In terms of non-invasive technology, I think CT angio is one of the most robust and accurate techniques. With the new development of FFR CT which was mentioned briefly during the session, I think this is a very exciting technique. It was awarded the innovation award at last years meeting here in Paris. We will see what comes from this. There is one multi-centered trial, the Discover FLOW Trial showing a very good correlation of FFR CT with invasive FFR.
  As I mentioned earlier, we will have a new study at the ESC meeting in Munich, the DEFACTO Trial, which will give us more information about this. This also goes in the direction we had talked about before, about the combination of functional and anatomic information in one technique that will be provided by FFR CT.
  《国际循环》:随着新技术的发展,有很多新的临床工具可用于冠脉成像。请介绍能在临床应用的一些新型冠状动脉影像学检查方法?
  Gämperli博士:这取决于你更关注哪种检查,无创检查还是有创检查。在有创检查领域,当前最令人兴奋的技术之一就是光学相干成像。这一技术确实具有无与伦比的空间分辨率,可达到10 μm,这太了不起了。借助这一手段,我们目前可以显示斑块的细节,以往采用传统方法是无法显示的。我们可以观察到脂质核心的大小、看到薄的纤维帽和血栓里的微小裂隙。实施PCI之后,可以观察到支架扩张情况。可以观察动脉夹层。对我来讲,光学相干成像是有创检查领域最激动人心的进展。
  对于无创检查来讲,我认为CT血管造影是最有力的和最为准确的技术。可以采用新开发出来的、在本次年会期间简单介绍过的血流储备分数CT(FFR CT),我认为这是一项非常激动人心的技术。这一技术在去年巴黎的EuroPCR年会上获得了创新奖,我们会关注这一技术的作用。有一项多中心研究Discover FLOW试验显示FFR CT与有创的FFR检查具有非常好的相关性。
  正如我较早提到的,我们会在慕尼黑召开的ESC年会上公布一项新的研究——DEFACTO试验,该试验会为我们提供有关FFR CT更多的信息。FFR CT的问世同时符合我刚才谈到的发展趋势,就是一项技术应当既能提供功能信息又能提供解剖结构信息,而FFR CT正是这样的技术。

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