By Marc Dewey (auth.)
Cardiac computed tomography (CT) has develop into a hugely actual diagnostic modality that keeps to draw expanding consciousness. This commonly illustrated ebook goals to help the reader in integrating cardiac CT into day-by-day medical perform, whereas additionally reviewing its present technical prestige and functions. transparent assistance is supplied at the functionality and interpretation of imaging utilizing the newest know-how, which deals better assurance, higher spatial answer, and quicker imaging whereas additionally delivering useful information regarding cardiac illnesses. the categorical positive factors of scanners from all 4 major owners, together with those who have only in the near past develop into on hand, are offered. one of the wide variety of functions and concerns mentioned are coronary calcium scoring, coronary artery pass grafts, stents, and anomalies, cardiac valves and serve as, congenital and purchased center sickness, and radiation publicity. Upcoming scientific makes use of of cardiac CT, corresponding to hybrid imaging, education and follow-up after valve alternative, electrophysiology purposes, myocardial perfusion and fractional stream reserve evaluate, and plaque imaging, also are explored.
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Extra info for Cardiac CT
Invest Radiol 17:458–462 O’Brien JP, Srichai MB, Hecht EM, Kim DC, Jacobs JE (2007) Anatomy of the heart at multidetector CT: what the radiologist needs to know. Radiographics 27:1569–1582 Popma J (2005) Coronary angiography and intravascular ultrasound imaging. In: Zipes DP (ed) Braunwald’s heart disease: a textbook of cardiovascular medicine. Elsevier, Philadelphia Saremi F, Abolhoda A, Ashikyan O et al (2008) Arterial supply to sinuatrial and atrioventricular nodes: imaging with multidetector CT.
The sinus node artery (arrow in Panels A and B) is the ﬁrst branch of the LCX in this patient. 1 Coronary artery anatomy using a 17-segment model 3 Segment no. Vessel name Segment name 1 Right coronary artery (RCA) Proximal right coronary 2 Mid right coronary 3 Distal right coronary 4a Posterior descending arterya 4b Right posterolateral brancha 5 Left main coronary artery (LM) Left main coronary artery 6 Left anterior descending artery (LAD) Proximal left anterior descending 7 Mid left anterior descending 8 Distal left anterior descending 9 First diagonal branch 10 Second diagonal branch 11 Left circumﬂex artery (LCX) Proximal left circumﬂex 12 First (obtuse) marginal 13 Mid left circumﬂex 14 Second (obtuse) marginal 15 Distal left circumﬂexa 16 Intermediate branchb Intermediate branchb This segmentation is based on the AHA segmentation published in 1975 by Austen et al.
In these patients a low threshold to ischemia detection seems reasonable. Although calcium scoring in patients at intermediate risk seems reasonable, there is currently no data showing that this approach improves outcome (in a cost-effective manner). Contrast-enhanced CT angiography is currently not recommended in patients who do not have symptoms. While radiation exposure may become less of a concern with the development of low-dose scan protocols, there is still the need for intravenous injection of potentially harmful contrast media.