Current Status and Clinical Applications of Cardiac Multidetector Computed Tomography

Abstract

Contrast-enhanced multidetector-row computed tomography (MDCT) is now capable of providing high-quality noninvasive views of cardiac anatomy and ‘instant’ noninvasive coronary angiography. With current generation 64-slice scanners, MDCT can be performed in most patients with minimal patient discomfort and high diagnostic accuracy. MDCT may obviate the need for invasive diagnostic angiography in patients with borderline symptoms or equivocal noninvasive testing. It is useful in assessing the symptomatic patient postrevascularization and in emergency room triage in selected patients with chest pain. Calcified vessels are still difficult to assess, as is the accurate evaluation of implanted coronary stents. The volume of contrast material required for proper opacification limits the use of MDCT in patients with renal dysfunction, but newer emerging technologies will greatly improve these disadvantages in the near future. MDCT is expected to become an integral part of our diagnostic armamentarium in the cardiac patient.

Indications, imaging technique, and reading of cardiac computed tomography: survey of clinical practice

“…Moreover, cardiac CT provides morphological information and facilitates the evaluation of global and regional cardiac function (cardiac valves, perfusion, and vitality) [6][7][8]. Numerous scientific articles published in recent years testify to the intense research activities in the field of cardiac CT [5,[9][10][11][12][13][14][15][16].…”

Characteristics of Patients With a Significant Stenosis in a Conventional Coronary Angiogram With a Normal Multi-Detector Computed Tomographic Coronary Angiogram

“…[9][10][11][12] A recent study has demonstrated how much the latest improvement in MDCT technology with a faster gantry rotation time and submillimeter slices acquired with 64-slice CT scanners has led to an increase in segments of the coronary tree being evaluable for the detection of coronary artery stenosis. MDCT has been shown to be a reliable diagnostic technique for the evaluation of coronary artery stenoses.…”

“…MDCT has been shown to be a reliable diagnostic technique for the evaluation of coronary artery stenoses. [10][11][12][13] However, coronary calcification influences image quality, and blurring due to severe calcification can cause an image to be uninterpretable. [14][15][16][17][18] Furthermore, MDCT tends to overestimate the degree of stenosis compared with that of CCA.…”

“…[14][15][16][17][18] Furthermore, MDCT tends to overestimate the degree of stenosis compared with that of CCA. 10,11) Until now, Medline searches have not identified any reports that analyzed the characteristics of patients with false negatives using MDCT.…”

MDCT evaluation of the cardiac venous system

“…The advent of multidetector-row systems has made CT study of the heart possible, despite the heart's involuntary motion and complex anatomy, which have been the main hurdles for noninvasive cardiac imaging [3][4][5]. The use of cardiac synchronisation techniques and pharmacological agents for slowing the heart rate have in fact enabled the reduction of pulsatility artefacts and the attainment of submillimetre volumetric data sets of good diagnostic quality in any phase of the cardiac cycle [2,4].…”