Multislice computed tomography angiography in the diagnosis of cardiovascular disease: 3D visualizations

Abstract

Multislice computed tomography (CT) has been widely used in clinical practice for the diagnosis of cardiovascular disease due to its reduced invasiveness and high spatial and temporal resolution. As a reliable alternative to conventional angiography, multislice CT angiography has been recognized as the method of choice for detecting and diagnosing head and neck vascular disease, abdominal aortic aneurysm, aortic dissection, and pulmonary embolism. In patients with suspected coronary artery disease, although invasive coronary angiography still remains as the gold standard technique, multislice CT angiography demonstrates high diagnostic accuracy; in selected patients, it is considered as the first-line technique. The imaging diagnosis of cardiovascular disease is based on a combination of two-dimensional (2D) and three-dimensional (3D) visualization tools to enhance the diagnostic value. This is facilitated by reconstructed visualizations which provide additional information about the extent of the disease, an accurate assessment of the spatial relationship between normal structures and pathological changes, and pre-operative planning and post-procedure follow-up. The aim of the present article is to present an overview of the diagnostic performance of various 2D and 3D CT visualizations in cardiovascular disease, including multiplanar reformation, maximum intensity projection, volume rendering, and virtual intravascular endoscopy. The recognition of the potential value of these visualizations will assist clinicians in efficiently using the multislice CT imaging modality for the diagnostic management of patients with cardiovascular disease.

Three-Dimensional Visualization and Imaging of the Entry Tear and Intimal Flap of Aortic Dissection Using CT Virtual Intravascular Endoscopy

“…By contrast, VIE is performed by applying volume-rendered thresholds and spatial rendering to generate endoluminal views. VIE provides an excellent 3D view to clearly show the entry tear and intimal flap that may overcome the deficiency of the conventional CT [ 11 , 13 , 14 ]. To date, however, VIE has not yet been widely used in clinical practice.…”

The Effect of Bilateral Superior Laryngeal Nerve Lesion on Swallowing: A Novel Method to Quantitate Aspirated Volume and Pharyngeal Threshold in Videofluoroscopy

“…With 3D techniques, measurement of volume instead of area is relatively easy. For fluoroscopy imaging, biplanar techniques permit volume estimation [24]. However, high-dose radiation, expense and limited availability of equipment make biplanar fluoroscopy impractical and unethical for widespread clinical use.…”

3D Printed Models of Complex Anatomy in Cardiovascular Disease

“…28 Multislice CT angiography is the preferred method for diagnosis of aortic dissection with a sensitivity and specificity of nearly 100%. [29][30][31] CT angiography has been shown to be more sensitive than invasive angiography for diagnosis of aortic dissection. The 3D aortic arch is difficult to assess on an axial CT plane.…”

“…The 3D aortic arch is difficult to assess on an axial CT plane. Although, 3D reconstructions serve as valuable tools for more accurate assessment of aortic dissection, 30,31 the complex anatomical structures of thoracic aorta, in particular when dissection involving aortic arch present a challenge to decision-making process (Figure 3). The 3D printed models overcome these limitations by providing the exact individual anatomy of the cardiovascular pathology in each patient.…”