CHAPTER 6 Cardiovascular Computed Tomography
Non-contrast-enhanced computed tomography (CT) coronary calcium imaging is predictive of adverse coronary events, independently and beyond that of traditional risk factors, because calcium is a marker of the presence of coronary atherosclerosis.Contrast-enhanced CT coronary angiography is a reliable non-invasive diagnostic modality to rule out the presence of significant obstructive coronary artery disease in patients with low-to-intermediate pretest risk of CAD and stable heart rhythm. CT-coronary imaging of non-obstructive atherosclerotic disease of the coronary wall offers the opportunity to evaluate early manifestations of coronary atherosclerosis. Severe coronary calcifications and irregular heart rhythm significantly limit the evaluation of CT-coronary images while the relatively high radiation exposure is of concern. CT imaging for pulmonary embolism and acute aortic dissection is highly accurate and may be considered the first-choice diagnostic option. CT imaging of great thoracic vessels, for cardiac function, heart valves, cardiac tumours and thrombi, or pericardial disease is feasible but the non-radiation diagnostic modalities echocardiography or cardiac magnetic resonance (CMR) imaging should be considered as first diagnostic options.
Chapter 28)
