Utilidad de la resonancia magnética y de la tomografía computarizada en el diagnóstico de la enfermedad de las arterias coronarias
Resumen
Introducción: en los últimos años, el avance en métodos diagnósticos no invasivos como la resonancia magnética y la tomografía computarizada ha permitido la valoración de estructuras anatómicas complejas, con lo que se ha desarrollado un creciente interés en la evaluación de pacientes con sospecha de enfermedad coronaria. Desde el punto de vista radiológico, la valoración de las arterias coronarias ha presentado múltiples retos, incluyendo el tamaño pequeño de las estructuras a evaluar, el movimiento constante del corazón y el movimiento respiratorio. Objetivo: describir los hallazgos imaginológicos y la utilidad diagnóstica de la resonancia magnética y de la tomografía computarizada en pacientes con sospecha de enfermedad coronaria. Materiales y métodos: se realizó un estudio descriptivo de serie de casos para el diagnóstico de pacientes con sospecha de enfermedad coronaria, en una institución de ayudas diagnósticas de alta complejidad de la ciudad de Medellín, Colombia. Resultados: se evaluaron cuatro casos de pacientes con sospecha de enfermedad coronaria. En el primero de la serie se demuestra la utilidad de la angiotomografía coronaria en un paciente con riesgo intermedio y prueba de esfuerzo con ejercicio no concluyente. En los dos casos siguientes, se demuestra la utilidad de la tomografía y la resonancia magnética para valorar las relaciones anatómicas en las anomalías del origen y del curso de estas arterias. Finalmente, se presenta un caso de fístula coronaría y la valoración de esta rara enfermedad por medio de la resonancia magnética. Conclusión: la angiotomografía y la resonancia magnética son herramientas diagnósticas de gran utilidad para la detección de la enfermedad coronaria de manera no invasiva. En la actualidad, son consideradas el estándar de oro para la valoración anatómica en casos de anomalías del origen o el curso, y cada día juegan un papel más importante en la exclusión de la enfermedad ateroesclerótica, la cual es una de las principales causas de mortalidad en los países desarrollados.
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