From the Guidelines
Cardiac Computed Tomography (CT) is a useful diagnostic tool for evaluating cardiac structure and function, particularly in cases where echocardiography is not diagnostic and cardiac magnetic resonance (CMR) imaging is unavailable 1.
Key Uses of Cardiac CT
- Assessing myocardial structure and function: Cardiac CT provides excellent spatial resolution, allowing for clear definition of left ventricular (LV) structure, including hypertrophy pattern, wall thickness measurement, detection of subaortic membrane, and intracardiac thrombus 1.
- Evaluating coronary anatomy: CT can provide an assessment of coronary anatomy, including stenosis and anomalous origin of coronary arteries 1.
- Quantifying ventricular volume and ejection fraction: CT can provide quantitative measurements of right ventricular (RV) and LV volume and ejection fraction, which is useful in patients who are not candidates for MRI 1.
Limitations of Cardiac CT
- Radiation exposure: Cardiac CT involves the use of radiation, which is a significant drawback, particularly for serial use 1.
- Inferior temporal resolution: CT has inferior temporal resolution compared with echocardiography and CMR 1.
- Need for dedicated expertise: Cardiac CT requires dedicated expertise to correctly perform and interpret scans, particularly in complex congenital heart disease cases 1.
From the Research
Utility of Cardiac Computed Tomography (CT)
The utility of cardiac Computed Tomography (CT) can be summarized as follows:
- Cardiac CT is a rapidly growing diagnostic area that allows for the noninvasive visualization of plaque burden and luminal obstruction in the coronary arteries 2.
- It has several indications, including risk stratification, disease detection, coronary plaque quantification, and planning for structural intervention 3.
- Cardiac CT is useful in assessing atherosclerotic plaque, chest pain evaluation, cardiovascular risk stratification, and guiding coronary intervention 4.
- It is also useful in ruling out coronary artery disease, with robust diagnostic accuracy, accessibility, and safety 5.
Diagnostic Capabilities
The diagnostic capabilities of cardiac CT include:
- Visualizing coronary artery calcification (CAC) and luminal obstruction (computed tomographic angiography [CTA]) noninvasively 2.
- Detecting subclinical atherosclerosis with minimal radiation and no contrast 2.
- Evaluating branches of the coronary artery and simultaneous analysis of other cardiac structures 2.
- Assessing myocardial imaging, perfusion scanning, and periprocedural planning, execution, and monitoring 5.
Clinical Applications
The clinical applications of cardiac CT include: