Computed tomography of the normal and infarcted myocardium

Adams, Douglass F.; Hessel, Samuel J.; Judy, Philip F.; Stein, J. A.; Abrams, Herbert L.

doi:10.2214/ajr.126.4.786

Cited by 79 publications

(19 citation statements)

References 1 publication

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“…These include: thinning of the myocardial walt in the region of the infarct zone; thrombus formation Within the left ventricular cavity; dilation of the left ventricular cavity with or without aneurysm formation. All of these findings may be demonstrated by CT (16)(17)(18)(19).…”

Section: Acute Myocardial Infarctionmentioning

confidence: 88%

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Computed axial tomography of the heart

1985

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CT scanning provides useful cardiac imaging but has not become a routine clinical tool for heart disease due to long exposure times (2-5 seconds) and the limitation of single slice acquisition. A revolutionary high speed (Cine) CT electron beam scanner was designed at UCSF, with multilevel millisecond scanning speed at rates of 17 scans per second. Table tilt and swivel permits direct imaging in various planes including the half axis view. Images can be analysed as closed loop movies, and quantitation of wall thickening, wall mass and ejection fractions are being validated. High resolution imaging without the need for gated acquisition is a significant advantage over nuclear medicine and magnetic resonance imaging, and physiology can be studied with exercise of other interventions. Fast CT can measure vessel blood flow and has great potential for estimating myocardial perfusion using indicator dilution theory and small peripheral intravenous injection of contrast medium. Cine CT could become the noninvasive modality of choice in cardiovascular diagnosis - the scanner has universal application for all organ systems.

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Section: Acute Myocardial Infarctionmentioning

confidence: 88%

“…Indentification of myocardial ischemia has been an attractive prospect since the first CT scanner became available (16). Laboratory studies have indicated that acute myocardial infarction can be recognized by contrast enhanced CT (17).…”

Section: Acute Myocardial Infarctionmentioning

confidence: 99%

Computed axial tomography of the heart

1985

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“…First attempts of CTP at rest were conducted in the late 70' by using first-generation single section CT scanner (11,12). However, the advent of multidetector row (≥64 slices) CT systems, with improvement in temporal, spatial and contrast resolution as well as volume coverage due to increased detector rows, faster gantry rotation and smaller isotropic voxel size, allow CT to demonstrate myocardial perfusion at rest and during pharmacologic stress.…”

Section: Review Articlementioning

confidence: 99%

Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography

Cademartiri

Seitun

Clemente

et al. 2017

Cardiovasc. Diagn. Ther.

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During the last decade coronary computed tomography angiography (CTA) has become the preeminent noninvasive imaging modality to detect coronary artery disease (CAD) with high accuracy.However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging. Myocardial CTP imaging can be performed with a single static scan during first pass of the contrast agent, with monoenergetic or dualenergy acquisition, or as a dynamic, time-resolved scan during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson). A number of CTP techniques are available, which can assess myocardial perfusion in both a qualitative, semi-quantitative or quantitative manner. Once used primarily as research tools, these modalities are increasingly being used in routine clinical practice. All these techniques offer the substantial advantage of combining anatomical and functional evaluation of flow-limiting coronary stenosis in the same examination that would be beneficial for clinical decision-making. This review focuses on the state-of the-art and future trends of these evolving imaging modalities in the field of cardiology for the physiologic assessments of CAD.

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“…These areas are sliced more tangentially by the usual slice plane and partial volume effects decrease image information. In experimental studies using canines, CT enables clear deliniation of the ischemic myocardium irnmediately after ligation of a coronary artery based on the density difference of normal and ischemic myocardium after contrast injection [1,[13][14][15][16].This model has been used for the quantitative assessment of changes in perfusion and size of ischemic areas following administration of several drugs. In patients with coronary bypass grafts CT enables non invasive evaluation of the perfusion of the coronary bypass grafts.…”

Section: Diagnostic Possibilitiesmentioning

confidence: 99%

Conventional computerized tomography of the heart

1988

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Ungated cardio-CT provides good morphologic information in the case of congenital heart disease, volume or pressure loading, left ventricular aneurysm, tumours, thrombi, cardiac calcifications and pericardial diseases. It allows qualitative assessments of myocardial thickness and perfusion of coronary bypass grafts. ECG-gated cardio-CT allows a quantitative assessment of systolic and diastolic myocardial thickness, volume calculation of cardiac cavities and evaluation of functional parameters. The correlation of the calculated left ventricular ejection fraction comparing laevocardiography and ECG-gated cardio-CT was poor (r = 0.7) mainly due to the comparable poor time resolution on the side of cardio-CT (approximately 0.1s). The quantitative analysis of regional wall motion based on cardio-CT showed for the diagnosis of pathologic wall motion a specificity of 80.5%, sensitivity of 73.9% and accuracy of 75.7%. Side effects must be taken into account following the injection of 200-250 ml hyperosmolar contrast medium during 5-10 minutes which causes intravascular fluid retention and cardiac volume loading. Patients prone to cardiac decompensation should be excluded from cardio-CT examinations.

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Computed tomography of the normal and infarcted myocardium

Cited by 79 publications

References 1 publication

Computed axial tomography of the heart

Computed axial tomography of the heart

Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography

Conventional computerized tomography of the heart

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