Principles and Applications
Because of its widespread availability and its cost-effectiveness, echocardiography represents the primary method of choice to image the pericardium. However, echocardiography is operator-dependent, and it often fails to detect the entire pericardium. Thus it is limited in the assessment of the severity of pericardial involvement in various diseases affecting the pericardium. Nataf et al. have demonstrated...
Imaging of the heart with computed tomography (CT) is challenging because the heart is continuously moving during data acquisition. As a result of the limited temporal resolution, the use of single-detector helical CT for noninvasive cardiac imaging was limited and resulted often in images with a high content of artifacts. The introduction of multidetector-row CT (MDCT) scanners by the end of 1998...
Congenital heart disease (CHD) is defined as abnormal development of heart structures during intrafetal life, resulting in more or less complex malformations of the heart and great vessels. Many patients benefit by surgical intervention or percutaneous interventional radiological procedures to correct the anatomical anomalies. These interventions have become more and more successful, allowing for...
Although the use of computed tomography (CT) in cardiac imaging mainly focuses on coronary artery disease and its sequelae, there are many more indications in which CT can provide excellent and valuable information. This has already been reported based on studies with electron beam CT (EBCT). The rapidly emerging and vastly growing interest and knowledge in cardiac CT today is mainly caused by the...
For the diagnosis, disease stratification, treatment planning, and prognosis of different cardiac diseases clinically presenting with myocardial dysfunction and regional or global ischemia, respectively, the accurate and reproducible determination of left-ventricular myocardial function is fundamental. Heart failure afflicts about 4.5 to 5 million people in the United States, with more than 500,000...
Coronary arterial disease is currently diagnosed and treated primarily on the basis of its impact on the large-diameter epicardial arteries. A structural change, usually a localized narrowing (stenosis) of a coronary artery lumen, is generally detected and quantitated by selective coronary angiography. However, by the time the epicardial artery stenosis results in reduced epicardial flow and the patient...
Because the myocardial reperfusion status is pivotal to the prognosis of patients who have suffered an acute myocardial infarction (AMI), the assessment of microvascular flow after reperfusion therapy is of great importance.
The cardiologist and radiologist interpreting coronary computed tomography angiography (CTA) should be familiar with coronary artery anatomy. It has a standard logical structure with some common variations and only a few rare abnormalities. In a conventional selective coronary angiography, blood in the chambers and coronary veins does not interfere with the visualization of the coronary arteries....
Contrast-enhanced computed tomography (CT) studies of the coronary arteries were performed first to visualize the vessel lumen and to achieve an angiographic-like presentation of the coronary arteries in combination with 3D postprocessing methods (1). Because short exposure times are essential for coronary CT angiography (CTA), investigations initially were performed with electron beam CT (EBCT) scanners...
Conventional catheter angiography is based on capturing X-ray images of the iodinated contrast material (CM) while it flows into the vessels. Computed tomography angiography (CTA) is based on the same concept, scanning the patient and his/her heart while a high concentration of iodinated CM flows through the coronary arteries (1). The CM inside the vessels increases the density of the vessel lumen...
One of the critical components for effective cardiac computed tomography (CT) application is a fully integrated and optimized image visualization, postprocessing, and analysis tool. Study of native axial images is not enough to assess all cardiac structures, especially coronary arteries (Fig. 1). Postprocessing is critical to visualize the arterial system and heart chambers. Specific tools have been...
In Summer 2002, a 21-yr-old man was found dead one early morning in his apartment. He had been a healthy sportsman, but sometimes he felt an atypical pressure in the left side of his chest, independent of body stress. In all former medical examinations (i.e., electrocardiogram [ECG], stress ECG, and echocardiography), particularly in the armed forces, no pathological diagnosis had been found. The...
Kawasaki disease is an acute febrile illness, causing mucosal inflammation, skin rash, and cervical lymphadenopathy, recognized most often in children younger than 4 yr of age. It was first described by Dr. Tomisaku Kawasaki in Japanese literature in 1967 (1), and then in English in 1974 (2). The disease is of unknown etiology that produces a systemic vasculitis, which is most severe in the medium-sized...
Minimally invasive coronary artery bypass surgery is gaining increasing clinical importance as an alternative procedure to conventional open-chest techniques (1,2). Recent technical developments in the field of computer-enhanced technology have markedly reduced surgical access, now enabling the clinical use of entirely closed-chest procedures such as totally endoscopic coronary artery bypass grafting...
With the advent of subsecond rotation combined with prospective electrocardiogram (ECG) triggering or retrospective ECG gating, conventional computed tomography (CT) with spiral capability and superior general image quality has challenged electron beam CT (EBCT) in the domain of cardiac imaging. The introduction of multislice CT scanning with the Siemens SOMATOM Volume Zoom with 4 simultaneously scanned...
High-pressure stent implantation is an established technique to maintain luminal integrity following interventional revascularization in native coronary arteries and bypass grafts. Large controlled randomized trials demonstrated superior long-term patency in comparison to percutaneous transluminal coronary angioplasty (PTCA) alone (8–13). The beneficial effects of stent implantation on restenosis...
In the past decade we have witnessed the development of noninvasive coronary imaging using different imaging modalities. Computed tomography (CT) and magnetic resonance imaging (MRI) modalities have been applied for the quantification of coronary calcium, detection of coronary and bypass graft occlusion, and most recently the characterization of noncalcified plaque material. However, the decisive...
Electron-beam computed tomography (EBCT) and multislice CT (MSCT) are used for the detection and quantification of coronary calcium, which is a good indicator of coronary atherosclerosis and total plaque burden (1–6). It is suggested that the coronary calcium score can be used to predict future coronary events in asymptomatic patients (3–7). However, acute coronary events are initiated by rupture...