ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:56

Article

Taylor, Allen J.^1,2  Cerqueira, Manuel³  Hodgson, John McB.⁴  Mark, Daniel⁵  Min, James⁶  O'Gara, Patrick^7,8  Rubin, Geoffrey D.⁹ 

[1] Appropriate Use Criteria Cardiac Computed Tomog W, Washington, DC USA

[2] Washington Hosp Ctr, Washington, DC 20010 USA

[3] Cleveland Clin Fdn, Cleveland, OH 44195 USA

[4] Dept Cardiol Geisinger Hlth Syst, Danville, PA USA

[5] Duke Univ, Duke Clin Res Inst, Durham, NC USA

[6] Weill Cornell Med Coll, New York, NY USA

[7] Harvard Univ, Sch Med, Boston, MA USA

[8] Brigham & Womens Hosp, Boston, MA 02115 USA

[9] Stanford Univ, Sch Med, Palo Alto, CA 94304 USA

关键词: ACCF Appropriate Use Criteria;    coronary artery bypass graft surgery;    coronary artery disease;    coronary heart disease;    coronary calcium score;    computed tomography;    computed tomographic angiography;    electrocardiogram;    heart failure;    estimated metabolic equivalents of exercise;    myocardial infarction;    percutaneous coronary intervention;    perioperative evaluation;   

DOI  :  10.1016/j.jacc.2010.07.005

来源: Elsevier

【 摘 要 】

The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate-and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research.

【 授权许可】

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