Computed Tomography

  • John Joseph SheehanEmail author
  • Jennifer Ilene Berliner
  • Karin Dill
  • James Christian Carr


Cardiac imaging was previously confined to plain film, invasive coronary angiography (ICA), nuclear medicine and echocardiography. Non invasive imaging of the heart with computed tomography (CT) and magnetic resonance imaging (MRI) has changed our approach to imaging cardiac disease. The advent of multidetector computed tomography (MDCT) with electrocardiographic (ECG) synchronization has established several clinical roles in the evaluation of coronary artery disease (CAD), coronary artery anomalies, coronary stent, coronary by-pass analysis and coronary plaque characterization. In addition, MDCT can assess myocardial perfusion, myocardial viability, valves, coronary veins and pulmonary veins.


Compute Tomography Angiography Pulmonary Vein Coronary Artery Calcification Coronary Compute Tomography Angiography Hounsfield Unit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Huda W, Slone RM. Review of Radiologic Physics. 2nd ed. Baltimore, MD: Lippincott Williams and Wilkins; 2003:16–130.Google Scholar
  2. 2.
    Mahesh M, Cody DD. Physics of cardiac imaging with multiple-row detector CT. Radiographics. 2007;27(5):1495–1509.PubMedCrossRefGoogle Scholar
  3. 3.
    Jahnke C, Paetsch I, Achenbach S, et al. Coronary MR imaging: breath-hold capability and patterns, coronary artery rest periods, and beta-blocker use. Radiology. 2006;239(1):71-78.PubMedCrossRefGoogle Scholar
  4. 4.
    Ruzsics B, Lee H, Zwerner PL, et al. Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience. Eur Radiol. 2008; 18(11):2414–2424.PubMedCrossRefGoogle Scholar
  5. 5.
    Hsieh J, Londt J, Vass M, et al. Step-and-shoot data acquisition and reconstruction for cardiac x-ray computed tomography. Med Phys. 2006;33(11):4236–4248.PubMedCrossRefGoogle Scholar
  6. 6.
    Earls JP, Berman EL, Urban BA, et al. Prospectively gated transverse coronary CT angiography versus retrospectively gated helical technique: improved image quality and reduced radiation dose. Radiology. 2008;246(3):742–753.PubMedCrossRefGoogle Scholar
  7. 7.
    Hunold P, Vogt FM, Schmermund A, et al. Radiation exposure during cardiac CT: effective doses at multi-detector row CT and electron-beam CT. Radiology. 2003;226(1):145–152.PubMedCrossRefGoogle Scholar
  8. 8.
    Hoffmann U, Ferencik M, Cury RC, et al. Coronary CT angiography. J Nucl Med. 2006; 47(5):797–806.PubMedGoogle Scholar
  9. 9.
    Schoepf UJ. CT of the Heart – Principles and Applications. Totowa, NJ: Humana Press; 2005 [ chapter 3].
  10. 10.
    Paul JF, Abada HT. Strategies for reduction of radiation dose in cardiac multislice CT. Eur Radiol. 2007;17(8):2028–2037.PubMedCrossRefGoogle Scholar
  11. 11.
    Raff GL, Gallagher MJ, O’Neill WW, et al. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol. 2005; 46(3):552–557.PubMedCrossRefGoogle Scholar
  12. 12.
    Johnson TR, Nikolaou K, Wintersperger BJ, et al. Dual-source CT cardiac imaging: initial experience. Eur Radiol. 2006;16(7):1409–1415.PubMedCrossRefGoogle Scholar
  13. 13.
    Rodriguez-Granillo GA, Rosales MA, Degrossi E, et al. Modified scan protocol using multislice CT coronary angiography allows high quality acquisitions in obese patients: a case report. Int J Cardiovasc imaging. 2007;23(2):265–267.PubMedCrossRefGoogle Scholar
  14. 14.
    Leschka S, Wildermuth S, Boehm T, et al. Noninvasive coronary angiography with 64-section CT: effect of average heart rate and heart rate variability on image quality. Radiology. 2006;241(2):378–385.PubMedCrossRefGoogle Scholar
  15. 15.
    Achenbach S, Ropers D, Kuettner A, et al. Contrast-enhanced coronary artery visualization by dual-source computed tomography – initial experience. Eur J Radiol. 2006;57(3):331–335.PubMedCrossRefGoogle Scholar
  16. 16.
    Arad Y, Goodman KJ, Roth M, et al. Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. J Am Coll Cardiol. 2005;46(1):158–165.PubMedCrossRefGoogle Scholar
  17. 17.
    Agatston AS, Janowitz WR, Hildner FJ, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15(4):827–832.PubMedCrossRefGoogle Scholar
  18. 18.
    Schoepf UJ, Becker CR, Ohnesorge BM, et al. CT of coronary artery disease. Radiology. 2004;232(1):18–37.PubMedCrossRefGoogle Scholar
  19. 19.
    Morin RL, Gerber TC, McCollough CH. Radiation dose in computed tomography of the heart. Circulation. 2003;107(6):917–922.PubMedCrossRefGoogle Scholar
  20. 20.
    Jakobs TF, Becker CR, Ohnesorge B, et al. Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur Radiol. 2002;12(5):1081–1086.PubMedCrossRefGoogle Scholar
  21. 21.
    Poll LW, Cohnen M, Brachten S, et al. Dose reduction in multi-slice CT of the heart by use of ECG-controlled tube current modulation (“ECG pulsing”): phantom measurements. Rofo. 2002;174(12):1500–1505.PubMedCrossRefGoogle Scholar
  22. 22.
    Burke AP, Kolodgie FD, Farb A, et al. Healed plaque ruptures and sudden coronary death: evidence that subclinical rupture has a role in plaque progression. Circulation. 2001;103(7):934–940.PubMedCrossRefGoogle Scholar
  23. 23.
    Kolodgie FD, Burke AP, Farb A, et al. The thin-cap fibroatheroma: a type of vulnerable plaque: the major precursor lesion to acute coronary syndromes. Curr Opin Cardiol. 2001; 16(5):285–292.PubMedCrossRefGoogle Scholar
  24. 24.
    Virmani R, Burke AP, Kolodgie FD, et al. Vulnerable plaque: the pathology of unstable coronary lesions. J Interv Cardiol. 2002;15(6):439–446.PubMedCrossRefGoogle Scholar
  25. 25.
    Virmani R, Kolodgie FD, Burke AP, et al. Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol. 2000;20(5):1262–1275.PubMedCrossRefGoogle Scholar
  26. 26.
    Shemesh J, Apter S, Itzchak Y, et al. Coronary calcification compared in patients with acute versus in those with chronic coronary events by using dual-sector spiral CT. Radiology. 2003;226(2):483–488.PubMedCrossRefGoogle Scholar
  27. 27.
    Beckman JA, Ganz J, Creager MA, et al. Relationship of clinical presentation and calcification of culprit coronary artery stenoses. Arterioscler Thromb Vasc Biol. 2001;21(10):1618–1622.PubMedCrossRefGoogle Scholar
  28. 28.
    Georgiou D, Budoff MJ, Kaufer E, et al. Screening patients with chest pain in the emergency department using electron beam tomography: a follow-up study. J Am Coll Cardiol. 2001;38(1):105–110.PubMedCrossRefGoogle Scholar
  29. 29.
    Shemesh J, Tenenbaum A, Fisman EZ, et al. Absence of coronary calcification on double-helical CT scans: predictor of angiographically normal coronary arteries in elderly women? Radiology. 1996;199(3):665–668.PubMedGoogle Scholar
  30. 30.
    Scanlon PJ, Faxon DP, Audet AM, et al. ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol. 1999;33(6):1756–1824.PubMedCrossRefGoogle Scholar
  31. 31.
    American Heart Association (ASA). Heart and Stroke Statistical Update. Dallas, DX: The American Heart Association; 2002.Google Scholar
  32. 32.
    Brenner DJ, Hall EJ. Computed tomography – an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277–2284.PubMedCrossRefGoogle Scholar
  33. 33.
    Hendel RC, Patel MR, Kramer CM, et al. ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol. 2006;48(7):1475–1497.PubMedCrossRefGoogle Scholar
  34. 34.
    Scheffel H, Alkadhi H, Plass A, et al. Accuracy of dual-source CT coronary angiography: first experience in a high pre-test probability population without heart rate control. Eur Radiol. 2006;16(12):2739–2747.PubMedCrossRefGoogle Scholar
  35. 35.
    Vogel-Claussen J, Pannu H, Spevak PJ, et al. Cardiac valve assessment with MR imaging and 64-section multi-detector row CT. RadioGraphics. 2006;26(6):1769–1784.Google Scholar
  36. 36.
    Faletra FF, Alain M, Moccetti T. Blockage of bileaflet mitral valve prosthesis imaged by computed tomography virtual endoscopy. Heart. 2007;93:324.PubMedCrossRefGoogle Scholar
  37. 37.
    Canty JM Jr, Judd RM, Brody AS, et al. First-pass entry of nonionic contrast agent into the myocardial extravascular space. Effects on radiographic estimates of transit time and blood volume. Circulation. 1991;84:2071–2078.PubMedCrossRefGoogle Scholar
  38. 38.
    Lardo AC, Cordeiro M, Silva C, et al. Contrast enhanced multidetector computed tomography viability imaging after myocardial infarction: characterization of myocyte death, microvascular obstruction, and chronic scar. Circulation. 2006;113:394–404.PubMedCrossRefGoogle Scholar
  39. 39.
    Araoz PA, Mulvagh S, Tazelaar HD, et al. CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. RadioGraphic. 2000;20(5):1303–1317.Google Scholar
  40. 40.
    Jongbloed MR, Dirksen M, Bax JJ, et al. Atrial fibrillation: multi-detector row CT of pulmonary vein anatomy prior to radiofrequency catheter ablation – initial experience. Radiology. 2005;234:702–709.PubMedCrossRefGoogle Scholar
  41. 41.
    Lacomis JM, Goitein O, Deible C, et al. CT of the pulmonary veins. J Thorac Imaging. 2007;22:63–76.PubMedCrossRefGoogle Scholar
  42. 42.
    Martinek M, Nesser H, Aichinger J, et al. Impact of integration of multislice computed tomography imaging into three-dimensional electroanatomic mapping on clinical outcomes, safety, and efficacy using radiofrequency ablation for atrial fibrillation. Pacing Clin Electrophysiol. 2007;30(10):1215–1223.PubMedCrossRefGoogle Scholar
  43. 43.
    Lobel R, Lustgarten DL, Spector PS. Multidetector computed tomography guidance in complex cardiac ablations. Coron Artery Dis. 2006;17:125–130.PubMedCrossRefGoogle Scholar
  44. 44.
    Scharf C, Sneider M, Morady F, et al. Anatomy of the pulmonary veins in patients with atrial fibrillation and effects of segmental ostial ablation analyzed by computed tomography. J Cardiovasc Electrophysiol. 2003;14:150–155.PubMedCrossRefGoogle Scholar
  45. 45.
    Saad EB, Rossillo A, Saad CP, et al. Pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation, functional characterization, evolution, and influence of the ablation strategy. Circulation. 2003;108:3102–3107.PubMedCrossRefGoogle Scholar

Copyright information

© Springer London 2010

Authors and Affiliations

  • John Joseph Sheehan
    • 1
    Email author
  • Jennifer Ilene Berliner
  • Karin Dill
  • James Christian Carr
  1. 1.Department of Cardiovascular ImagingFeinberg School of Medicine, Northwestern UniversityChicagoUSA

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