Abstract
The clinically most relevant indications for cardiac CT are presented. CT angiography for ruling out coronary artery disease in patients with low-to-intermediate pretest likelihood of disease is the most common appropriate indication. Assessing myocardial viability by CT and performing coronary CT angiography in asymptomatic individuals and patients with typical symptoms and high likelihood of coronary artery disease are not recommended.
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Achenbach S (2006) Computed tomography coronary angiography. J Am Coll Cardiol 48:1919–1928
Bluemke DA, Achenbach S, Budoff M et al (2008) Noninvasive coronary artery imaging: magnetic resonance angiography and multidetector computed tomography angiography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young. Circulation 118:586–606
Cademartiri F, Schuijf JD, Pugliese F et al (2007) Usefulness of 64-slice multislice computed tomography coronary angiography to assess in-stent restenosis. J Am Coll Cardiol 49:2204–2210
Chinnaiyan KM, Raff GL, Goraya T et al (2012) Coronary computed tomography angiography after stress testing: results from a multicenter, statewide registry, ACIC (Advanced Cardiovascular Imaging Consortium). J Am Coll Cardiol 59:688–695
Cordeiro MA, Lima JA (2006) Atherosclerotic plaque characterization by multidetector row computed tomography angiography. J Am Coll Cardiol 47:C40–C47
Cury RC, Feuchtner GM, Batlle JC et al (2013) Triage of patients presenting with chest pain to the emergency department: implementation of coronary CT angiography in a large urban health care system. AJR Am J Roentgenol 200:57–65
de Roos A, Kroft LJ, Bax JJ et al (2007) Applications of multislice computed tomography in coronary artery disease. J Magn Reson Imaging 26:14–22
Dewey M, Hamm B (2007) CT coronary angiography: examination technique, clinical results, and outlook on future developments. Fortschr Röntgenstr 179:246–260
Dewey M, Müller M, Eddicks S et al (2006a) Evaluation of global and regional left ventricular function with 16-slice computed tomography, biplane cineventriculography, and two-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging. J Am Coll Cardiol 48:2034–2044
Dewey M, Teige F, Schnapauff D et al (2006b) Noninvasive detection of coronary artery stenoses with multislice computed tomography or magnetic resonance imaging. Ann Intern Med 145:407–415
Diamond GA, Forrester JS (1979) Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med 300:1350–1358
Ehara M, Kawai M, Surmely JF et al (2007) Diagnostic accuracy of coronary in-stent restenosis using 64-slice computed tomography: comparison with invasive coronary angiography. J Am Coll Cardiol 49:951–959
Feuchtner GM, Dichtl W, Friedrich GJ et al (2006a) Multislice computed tomography for detection of patients with aortic valve stenosis and quantification of severity. J Am Coll Cardiol 47:1410–1417
Feuchtner GM, Dichtl W, Schachner T et al (2006b) Diagnostic performance of MDCT for detecting aortic valve regurgitation. AJR Am J Roentgenol 186:1676–1681
Garcia MJ, Lessick J, Hoffmann MH (2006) Accuracy of 16-row multidetector computed tomography for the assessment of coronary artery stenosis. JAMA 296:403–411
Gaspar T, Halon DA, Lewis BS et al (2005) Diagnosis of coronary in-stent restenosis with multidetector row spiral computed tomography. J Am Coll Cardiol 46:1573–1579
Gasparovic H, Rybicki FJ, Millstine J et al (2005) Three dimensional computed tomographic imaging in planning the surgical approach for redo cardiac surgery after coronary revascularization. Eur J Cardiothorac Surg 28:244–249
Gilard M, Cornily JC, Pennec PY et al (2006) Assessment of coronary artery stents by 16 slice computed tomography. Heart 92:58–61
Goldstein JA, Chinnaiyan KM, Abidov A et al (2011) The CT-STAT (Coronary Computed Tomographic Angiography for Systematic Triage of Acute Chest Pain Patients to Treatment) trial. J Am Coll Cardiol 58:1414–1422
Hamon M, Biondi-Zoccai GG, Malagutti P et al (2006) Diagnostic performance of multislice spiral computed tomography of coronary arteries as compared with conventional invasive coronary angiography: a meta-analysis. J Am Coll Cardiol 48:1896–1910
Hamon M, Champ-Rigot L, Morello R et al (2008) Diagnostic accuracy of in-stent coronary restenosis detection with multislice spiral computed tomography: a meta-analysis. Eur Radiol 18(2):217–225
Hendel RC, Patel MR, Kramer CM et al (2006) ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. J Am Coll Cardiol 48:1475–1497
Hoffmann MH, Shi H, Schmitz BL et al (2005) Noninvasive coronary angiography with multislice computed tomography. JAMA 293:2471–2478
Hoffmann U, Pena AJ, Cury RC et al (2006) Cardiac CT in emergency department patients with acute chest pain. Radiographics 26:963–978; discussion 979–980
Hoffmann U, Truong QA, Schoenfeld DA et al (2012) Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med 367:299–308
Jones CM, Athanasiou T, Dunne N et al (2007) Multi-detector computed tomography in coronary artery bypass graft assessment: a meta-analysis. Ann Thorac Surg 83:341–348
Leber AW, Johnson T, Becker A et al (2007) Diagnostic accuracy of dual-source multi-slice CT-coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease. Eur Heart J 28(19):2354–2360
Litt HI, Gatsonis C, Snyder B et al (2012) CT angiography for safe discharge of patients with possible acute coronary syndromes. N Engl J Med 366:1393–1403
Madder RD, Raff GL, Hickman L et al (2011) Comparative diagnostic yield and 3-month outcomes of “triple rule-out” and standard protocol coronary CT angiography in the evaluation of acute chest pain. J Cardiovasc Comput Tomogr 5:165–171
Mahnken AH, Muhlenbruch G, Gunther RW et al (2007) Cardiac CT: coronary arteries and beyond. Eur Radiol 17:994–1008
Malagutti P, Nieman K, Meijboom WB et al (2006) Use of 64-slice CT in symptomatic patients after coronary bypass surgery: evaluation of grafts and coronary arteries. Eur Heart J 28:1879–1885
Martuscelli E, Romagnoli A, D’Eliseo A et al (2004) Evaluation of venous and arterial conduit patency by 16-slice spiral computed tomography. Circulation 110:3234–3238
Maurer MH, Zimmermann E, Schlattmann P et al (2012) Indications, imaging technique, and reading of cardiac computed tomography: survey of clinical practice. Eur Radiol 22:59–72
Meijboom WB, Mollet NR, Van Mieghem CA et al (2006) Pre-operative computed tomography coronary angiography to detect significant coronary artery disease in patients referred for cardiac valve surgery. J Am Coll Cardiol 48:1658–1665
Meijboom WB, van Mieghem CA, Mollet NR et al (2007) 64-slice computed tomography coronary angiography in patients with high, intermediate, or low pretest probability of significant coronary artery disease. J Am Coll Cardiol 50:1469–1475
Meyer TS, Martinoff S, Hadamitzky M et al (2007) Improved noninvasive assessment of coronary artery bypass grafts with 64-slice computed tomographic angiography in an unselected patient population. J Am Coll Cardiol 49:946–950
Mollet NR, Cademartiri F, Nieman K et al (2004) Multislice spiral computed tomography coronary angiography in patients with stable angina pectoris. J Am Coll Cardiol 43:2265–2270
Poon M, Rubin GD, Achenbach S et al (2007) Consensus update on the appropriate usage of cardiac computed tomographic angiography. J Invasive Cardiol 19:484–490
Raff GL, Chinnaiyan KM, Berman DS et al (2009) Coronary Computed Tomography for Systematic Triage of Acute Chest Pain Patients to Treatment – (The CT-STAT Trial). Circulation 120:2160
Rixe J, Achenbach S, Ropers D et al (2006) Assessment of coronary artery stent restenosis by 64-slice multi-detector computed tomography. Eur Heart J 27:2567–2572
Ropers U, Ropers D, Pflederer T et al (2007) Influence of heart rate on the diagnostic accuracy of dual-source computed tomography coronary angiography. J Am Coll Cardiol 50:2393–2398
Schoepf UJ, Zwerner PL, Savino G et al (2007) Coronary CT angiography. Radiology 244:48–63
Schuetz GM, Zacharopoulou NM, Schlattmann P et al (2010) Meta-analysis: noninvasive coronary angiography using computed tomography versus magnetic resonance imaging. Ann Intern Med 152:167–177
Stillman AE, Oudkerk M, Ackerman M et al (2007) Use of multidetector computed tomography for the assessment of acute chest pain: a consensus statement of the North American Society of Cardiac Imaging and the European Society of Cardiac Radiology. Eur Radiol 17:2196–2207
Truong QA, Hayden D, Woodard PK et al (2013) Sex differences in the effectiveness of early coronary computed tomographic angiography compared with standard emergency department evaluation for acute chest pain: the Rule-Out Myocardial Infarction with Computer-Assisted Tomography (ROMICAT)-II trial. Circulation 127:2494–2502
van der Vleuten PA, Willems TP, Gotte MJ et al (2006) Quantification of global left ventricular function: comparison of multidetector computed tomography and magnetic resonance imaging. a meta-analysis and review of the current literature. Acta Radiol 47:1049–1057
Van Mieghem CA, Cademartiri F, Mollet NR et al (2006) Multislice spiral computed tomography for the evaluation of stent patency after left main coronary artery stenting: a comparison with conventional coronary angiography and intravascular ultrasound. Circulation 114:645–653
Weustink AC, Meijboom WB, Mollet NR et al (2007) Reliable high-speed coronary computed tomography in symptomatic patients. J Am Coll Cardiol 50:786–794
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Dewey, M. (2014). Clinical Indications. In: Cardiac CT. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-41883-9_5
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DOI: https://doi.org/10.1007/978-3-642-41883-9_5
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