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Cardiac Computed Tomography

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Comprehensive Cardiovascular Medicine in the Primary Care Setting

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Computed tomography (CT) is one of the greatest innovations of the twentieth century, and it has revolutionized clinical practice. Sir Godfrey Hounsfield, an English engineer working for EMI, and Allan Cormack of Tufts University, Massachusetts, a South African-born physicist, developed the concept and the first computed axial tomographic (CAT) scanner in 1972. For the first time, a large volume of data could be collected in an orthogonal plane by using a thin X-ray beam to rotate around a region of interest. The earliest scanners took hours to acquire data and several days to reconstruct the final image for analysis. Subsequent advances such as “slip-ring” technology removed the need for a rigid mechanical linkage between the power cables and the X-ray tube. This enabled the X-ray tube to rotate indefinitely and resulted in spiral CT. CT imaging has become a cornerstone of clinical practice, and it is thought that over 62 million CT scans are performed each year in the USA

Key Points

• Multislice CT, with its high spatial and temporal resolution, has the unique capability to non-invasively visualize coronary artery plaque and stenosis.

• Cardiac CT uses ECG triggering and is a robust, fast (10 s), and relatively simple imaging test.

• Adequate patient selection and preparation are key for diagnostic image quality.

• Radiation exposure (7–20 mSv) and iodinated contrast administration (60–100 mL) are the risks associated with cardiac CT; the newest CT scanners allow a low radiation dose protocol (<5 mSv).

• Adequate use of post-processing and knowledge about artifacts are essential to achieve high diagnostic accuracy and to avoid unnecessary subsequent tests.

• The strength of cardiac CT is the exclusion of significant CAD in patients with an intermediate likelihood of CAD.

• Cardiac CT is limited in patients with known CAD.

• Cardiac CT may improve the management of patients with acute chest pain.

• Plaque assessment will potentially provide useful information for risk stratification and preventive therapy.

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Authors and Affiliations

  1. Cardiac MR PET CT Program, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    Patrick Donnelly MD & Udo Hoffmann MD

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  1. Patrick Donnelly MD
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  2. Udo Hoffmann MD
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Editors and Affiliations

  1. Sterling Rock Falls Clinic, 101 E. Miller Road, Sterling, 61081, USA

    Peter P. Toth

  2. Brigham & Women's Hospital, Cardiovascular Division, Harvard Medical School, Longwood Ave. 350, Boston, 02115, USA

    Christopher P. Cannon

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Donnelly, P., Hoffmann, U. (2011). Cardiac Computed Tomography. In: Toth, P., Cannon, C. (eds) Comprehensive Cardiovascular Medicine in the Primary Care Setting. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-963-5_27

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  • DOI: https://doi.org/10.1007/978-1-60327-963-5_27

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