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Technology Insight: possible applications of multislice computed tomography in clinical cardiology

Nature Clinical Practice Cardiovascular Medicine volume 2, pages 361–368 (2005)Cite this article

Abstract

With the introduction of four-slice scanners in 1999, multislice CT (MSCT) technology became available for investigative examination of the heart. Since then, MSCT technology has undergone rapid technical progress; temporal and spatial resolutions have been especially improved. The improved diagnostic image quality has led to more possible uses of MSCT being defined. At present, issues such as visualization of coronary artery bypass grafts, detection of stenoses of native coronary arteries, description of coronary anomalies, and calcium scoring, can be investigated reasonably well. Other features, such as plaque imaging and visualization of intracoronary stents, need further evaluation. A large number of factors, however, such as heart rate, atrial fibrillation, breathing artefacts and severe calcification, still influence image quality and reduce validity. In this article we provide a summary of current fields of application of cardiac MSCT. The word 'indication' is consciously avoided because official guidelines for the use of MSCT in heart examination have not yet been issued. Hopefully, prospective multicenter trials will be performed soon, providing more data with which to establish guidelines for both cardiologist and radiologist.

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Figure 1: Exclusion of coronary artery disease in the left arterior descending artery by use of noninvasive multislice CT compared with conventional coronary angiography.
Figure 2: Exclusion of coronary artery disease in the right coronary artery by use of noninvasive multislice CT compared with conventional angiography.
Figure 3: Aortocoronary venous bypass graft to the left anterior descending artery (thin arrow) and aortocoronary venous bypass graft to the diagonal side branch (thick arrow), in both of which occlusions can occur.
Figure 4: Severe calcifications and high-grade stenosis in the proximal left anterior descending artery.
Figure 5: Visualization of noncalcified and partly calcified plaques on multislice CT compared with conventional coronary angiography.
Figure 6: Use of multislice CT to assess left-ventricular function.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Cardiology,

    Torsten Beck, Christof Burgstahler, Anja Reimann, Axel Kuettner, Martin Heuschmid, Andreas F Kopp & Stephen Schroeder

  2. Department of Radiology, Division of Diagnostic Radiology, Eberhard-Karls-University Tuebingen, Germany

    Torsten Beck, Christof Burgstahler, Anja Reimann, Axel Kuettner, Martin Heuschmid, Andreas F Kopp & Stephen Schroeder

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  1. Torsten Beck
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Correspondence to Stephen Schroeder.

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Glossary

AGATSTON SCORE EQUIVALENT

Score for quantification of coronary calcification on CT; values of ≥130 HU in a region of interest show a density that relates to calcium deposits

HOUNSFIELD UNITS (HU)

Quantitative scale of radiodensity, in which 0 HU = radiodensity of distilled water at standard pressure, and −1,000 HU = radiodensity of air

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Beck, T., Burgstahler, C., Reimann, A. et al. Technology Insight: possible applications of multislice computed tomography in clinical cardiology. Nat Rev Cardiol 2, 361–368 (2005). https://doi.org/10.1038/ncpcardio0240

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