Pub Date : 2015-03-01DOI: 10.1093/med/9780198703341.003.0036
P. Nihoyannopoulos, P. Elliott, G. Captur
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited, progressive cardiomyopathy associated with high risk of ventricular tachycardia associated with right-sided structural disorders. More recent reports have shown that although the right ventricle (RV) is most often affected, the left ventricle (LV) is also commonly involved. This has led to the more recent term arrhythmogenic cardiomyopathy (AC). Men are more frequently affected than women and it is usually diagnosed between the second and fourth decade of life. The most common presentation is ventricular arrhythmia, specifically ventricular tachycardia originating from the RV with a characteristic left bundle-branch block (LBBB) morphology. ARVC is also an important cause of sudden death in individuals <30 years of age and has been found in up to 20% of sudden deaths in young individuals. Furthermore, ARVC is more common in athletes and disease expression is associated with high intensity exercise.
{"title":"Other genetic and acquired cardiomyopathies","authors":"P. Nihoyannopoulos, P. Elliott, G. Captur","doi":"10.1093/med/9780198703341.003.0036","DOIUrl":"https://doi.org/10.1093/med/9780198703341.003.0036","url":null,"abstract":"Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited, progressive cardiomyopathy associated with high risk of ventricular tachycardia associated with right-sided structural disorders. More recent reports have shown that although the right ventricle (RV) is most often affected, the left ventricle (LV) is also commonly involved. This has led to the more recent term arrhythmogenic cardiomyopathy (AC). Men are more frequently affected than women and it is usually diagnosed between the second and fourth decade of life. The most common presentation is ventricular arrhythmia, specifically ventricular tachycardia originating from the RV with a characteristic left bundle-branch block (LBBB) morphology. ARVC is also an important cause of sudden death in individuals <30 years of age and has been found in up to 20% of sudden deaths in young individuals. Furthermore, ARVC is more common in athletes and disease expression is associated with high intensity exercise.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130600943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-03-01DOI: 10.1093/med/9780198703341.003.0001
A. Hagendorff
Echocardiography is an imaging technique that enables accurate assessment of cardiac structures and cardiac function. Conventional echocardiography involves different modalities—especially the M-mode, the 2D, and colour Doppler, as well as the pulsed-wave and continuous wave Doppler. The M-mode illustrates the reflections of a single sound beam plotted against time. 2D echocardiography enables the documentation of views, which represent characteristic sectional planes of the moving heart during one heart cycle. Colour Doppler echocardiography adds the information of blood flow to the 2D cineloop. Pulsed-wave Doppler is the acquisition of a local blood flow spectrum of a defined region represented by the dimension of the sample volume, whereas continuous wave Doppler displays the blood flow spectrum of all measured blood flow velocities along a straight line sound beam from its beginning to the end. The handling of the transducer has to be target-oriented, stable with respect to the imaging targets, and coordinated with respect to angle differences between the defined views to use all these modalities correctly to get optimal image quality of the cineloops and spectra. Thus, the focus of this chapter will be a mainly practically oriented description of scanning technique in transthoracic and transoesophageal echocardiography.
{"title":"Conventional echocardiography—basic principles","authors":"A. Hagendorff","doi":"10.1093/med/9780198703341.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780198703341.003.0001","url":null,"abstract":"Echocardiography is an imaging technique that enables accurate assessment of cardiac structures and cardiac function. Conventional echocardiography involves different modalities—especially the M-mode, the 2D, and colour Doppler, as well as the pulsed-wave and continuous wave Doppler. The M-mode illustrates the reflections of a single sound beam plotted against time. 2D echocardiography enables the documentation of views, which represent characteristic sectional planes of the moving heart during one heart cycle. Colour Doppler echocardiography adds the information of blood flow to the 2D cineloop. Pulsed-wave Doppler is the acquisition of a local blood flow spectrum of a defined region represented by the dimension of the sample volume, whereas continuous wave Doppler displays the blood flow spectrum of all measured blood flow velocities along a straight line sound beam from its beginning to the end. The handling of the transducer has to be target-oriented, stable with respect to the imaging targets, and coordinated with respect to angle differences between the defined views to use all these modalities correctly to get optimal image quality of the cineloops and spectra. Thus, the focus of this chapter will be a mainly practically oriented description of scanning technique in transthoracic and transoesophageal echocardiography.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131638770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-03-01DOI: 10.1093/MED/9780198703341.003.0018
R. Sicari
Non-invasive imaging modalities play an important role in the evaluation and management of patients with known or suspected coronary heart disease (CAD). This chapter will describe how we should use echocardiography in acute and chronic CAD at rest and during stress. In patients with established or suspected CAD, echocardiography provides useful information on the status of global and segmental myocardial function, the presence of functional mitral regurgitation and potentially of other signs of myocardial ischaemia. Echocardiography can be used to identify complications such as severe ventricular failure, acute mitral regurgitation, papillary muscle rupture, wall rupture, left ventricular (LV) thrombus, and cardiac tamponade. Inducible ischaemia is typically evaluated by stress echocardiography and will also be discussed in this chapter.
{"title":"Echocardiography and detection of coronary artery disease","authors":"R. Sicari","doi":"10.1093/MED/9780198703341.003.0018","DOIUrl":"https://doi.org/10.1093/MED/9780198703341.003.0018","url":null,"abstract":"Non-invasive imaging modalities play an important role in the evaluation and management of patients with known or suspected coronary heart disease (CAD). This chapter will describe how we should use echocardiography in acute and chronic CAD at rest and during stress. In patients with established or suspected CAD, echocardiography provides useful information on the status of global and segmental myocardial function, the presence of functional mitral regurgitation and potentially of other signs of myocardial ischaemia. Echocardiography can be used to identify complications such as severe ventricular failure, acute mitral regurgitation, papillary muscle rupture, wall rupture, left ventricular (LV) thrombus, and cardiac tamponade. Inducible ischaemia is typically evaluated by stress echocardiography and will also be discussed in this chapter.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"194 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115761143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-03-01DOI: 10.1093/med/9780198703341.003.0010
H. Baumgartner, E. Donal, S. Orwat, A. Schmermund, R. Rosenhek, D. Maintz
Aortic valve stenosis (AS) is the most prevalent valvular heart disease and is increasingly diagnosed in high-income countries due to an ageing population but also to more widely available diagnostic tools. The prevalence of AS is estimated at ~0.5% in the general population, ~2–3% in the population over 65 years old. This disease starts with mild fibrosis and calcification and thickening of the aortic valve leaflets without obstruction of blood flow, which is termed aortic sclerosis, and evolves over the years to severe calcification with impaired leaflet mobility and significant obstruction to blood flow, i.e. AS. The clinical presentation includes the spectrum from asymptomatic patients with different grades (mild, moderate, severe) of AS severity to symptomatic patients with severe AS who may present with preserved or already depressed left ventricular (LV) function and/or reduced transvalvular flow. Accurate assessment of the AS anatomic and haemodynamic severity as well as the extent of cardiac damage associated with AS are crucial for the therapeutic management of patients with AS. Doppler-echocardiography is the method of choice providing a comprehensive non-invasive diagnostic work-up of these patients.
{"title":"Aortic valve stenosis","authors":"H. Baumgartner, E. Donal, S. Orwat, A. Schmermund, R. Rosenhek, D. Maintz","doi":"10.1093/med/9780198703341.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780198703341.003.0010","url":null,"abstract":"Aortic valve stenosis (AS) is the most prevalent valvular heart disease and is increasingly diagnosed in high-income countries due to an ageing population but also to more widely available diagnostic tools. The prevalence of AS is estimated at ~0.5% in the general population, ~2–3% in the population over 65 years old. This disease starts with mild fibrosis and calcification and thickening of the aortic valve leaflets without obstruction of blood flow, which is termed aortic sclerosis, and evolves over the years to severe calcification with impaired leaflet mobility and significant obstruction to blood flow, i.e. AS. The clinical presentation includes the spectrum from asymptomatic patients with different grades (mild, moderate, severe) of AS severity to symptomatic patients with severe AS who may present with preserved or already depressed left ventricular (LV) function and/or reduced transvalvular flow. Accurate assessment of the AS anatomic and haemodynamic severity as well as the extent of cardiac damage associated with AS are crucial for the therapeutic management of patients with AS. Doppler-echocardiography is the method of choice providing a comprehensive non-invasive diagnostic work-up of these patients.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125374665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-03-01DOI: 10.1093/med/9780198703341.003.0020
S. Achenbach
After the first introduction of CT angiography (CTA) in 1992, further technological advances, such as more powerful X-ray tubes, faster gantry rotation times, multiple parallel detector rings and decreased slice thickness led to progressively better and more stable image quality for visualization of the coronary arteries. Today, multidetector-row CT (MDCT) with gantry rotation times up to 240 milliseconds, a temporal resolution of up to 75 milliseconds, coverage in z-direction of up to 16 cm per rotation, and almost isotropic spatial resolution of as little as 0.4 mm allow for high-resolution, accurate imaging of the coronary artery wall and lumen. The quantification of calcified coronary atherosclerotic plaque burden (‘calcium score’) using native scans and the additional detection of non-calcified plaque and luminal narrowing through contrast-enhanced image acquisition (‘coronary CTA’) have established themselves as routine techniques in clinical practice which can be used not in all, but in many patients.
{"title":"MDCT and detection of coronary artery disease","authors":"S. Achenbach","doi":"10.1093/med/9780198703341.003.0020","DOIUrl":"https://doi.org/10.1093/med/9780198703341.003.0020","url":null,"abstract":"After the first introduction of CT angiography (CTA) in 1992, further technological advances, such as more powerful X-ray tubes, faster gantry rotation times, multiple parallel detector rings and decreased slice thickness led to progressively better and more stable image quality for visualization of the coronary arteries. Today, multidetector-row CT (MDCT) with gantry rotation times up to 240 milliseconds, a temporal resolution of up to 75 milliseconds, coverage in z-direction of up to 16 cm per rotation, and almost isotropic spatial resolution of as little as 0.4 mm allow for high-resolution, accurate imaging of the coronary artery wall and lumen. The quantification of calcified coronary atherosclerotic plaque burden (‘calcium score’) using native scans and the additional detection of non-calcified plaque and luminal narrowing through contrast-enhanced image acquisition (‘coronary CTA’) have established themselves as routine techniques in clinical practice which can be used not in all, but in many patients.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116926534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-03-01DOI: 10.1093/MED/9780198703341.003.0005
S. Gianstefani, J. Voigt, M. Monaghan
Despite the fact that three-dimensional echocardiography (3DE) has been available for many years, its utilization on a routine clinical basis has been rather limited. However, recent improvements in image quality, semi-automated quantification, better workflow, and other developments such as fusion imaging, have now accelerated the integration of 3D imaging into routine echo practice. In this chapter, we have reviewed the standard and well established applications of the technique such as volumetric chamber analysis and 3D evaluation of valvular pathology, as well as highlighting some of the exciting new developments such as the use of artificial intelligence and photo-realistic visualization. these newer techniques will undoubtedly help ensure that 3D echocardiography plays a pivotal role in contemporary cardiac imaging leading and cutting edge patient care.
{"title":"New developments in echocardiography/Advanced echocardiography","authors":"S. Gianstefani, J. Voigt, M. Monaghan","doi":"10.1093/MED/9780198703341.003.0005","DOIUrl":"https://doi.org/10.1093/MED/9780198703341.003.0005","url":null,"abstract":"Despite the fact that three-dimensional echocardiography (3DE) has been available for many years, its utilization on a routine clinical basis has been rather limited. However, recent improvements in image quality, semi-automated quantification, better workflow, and other developments such as fusion imaging, have now accelerated the integration of 3D imaging into routine echo practice. In this chapter, we have reviewed the standard and well established applications of the technique such as volumetric chamber analysis and 3D evaluation of valvular pathology, as well as highlighting some of the exciting new developments such as the use of artificial intelligence and photo-realistic visualization. these newer techniques will undoubtedly help ensure that 3D echocardiography plays a pivotal role in contemporary cardiac imaging leading and cutting edge patient care.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128562328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1093/med/9780198849353.003.0045
U. Tayal, S. Prasad, T. Germans, A. V. van Rossum
Dilated cardiomyopathy (DCM) is characterized by enlargement of the heart with associated reduced left ventricular function. From an imaging perspective, important requirements are to exclude other pathologies, assess disease severity, guide therapeutic management, and identify complications. Establishing the imaging diagnosis of DCM is key to guiding the management of DCM. In this chapter we discuss how to use imaging to make an accurate diagnosis of DCM, and review how to exclude coronary artery disease (CAD) and valvular disease as these are two important differentials with differing management strategies. We then review the diagnostic and prognostic capabilities of echocardiography, cardiovascular magnetic resonance imaging (CMR) and nuclear techniques including single-photon emission computed tomography (SPECT) and positron emission tomography (PET) in DCM, with a focus on where imaging can identify particular causes of DCM.
{"title":"Dilated cardiomyopathy","authors":"U. Tayal, S. Prasad, T. Germans, A. V. van Rossum","doi":"10.1093/med/9780198849353.003.0045","DOIUrl":"https://doi.org/10.1093/med/9780198849353.003.0045","url":null,"abstract":"Dilated cardiomyopathy (DCM) is characterized by enlargement of the heart with associated reduced left ventricular function. From an imaging perspective, important requirements are to exclude other pathologies, assess disease severity, guide therapeutic management, and identify complications. Establishing the imaging diagnosis of DCM is key to guiding the management of DCM. In this chapter we discuss how to use imaging to make an accurate diagnosis of DCM, and review how to exclude coronary artery disease (CAD) and valvular disease as these are two important differentials with differing management strategies. We then review the diagnostic and prognostic capabilities of echocardiography, cardiovascular magnetic resonance imaging (CMR) and nuclear techniques including single-photon emission computed tomography (SPECT) and positron emission tomography (PET) in DCM, with a focus on where imaging can identify particular causes of DCM.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124419052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1093/med/9780198849353.003.0020
D. Muñoz, Á. M. del Castillo
Cardiac imaging is the cornerstone in the diagnosis of endocarditis. It plays a key role in the confirmation of the diagnosis, location, and extension of the disease, as well as on the evaluation of associated lesions that directly impact treatment options. Echocardiography, both transthoracic and transoesophageal, are the main tools in the diagnostic process. However, alternative imaging techniques have emerged to compensate some of their pitfalls. In this chapter, we review the potential findings as well as the advantages and limitations of each technique. A correct understanding of the information they can provide is essential both for the clinical cardiologist and the specialist in cardiac imaging.
{"title":"Endocarditis","authors":"D. Muñoz, Á. M. del Castillo","doi":"10.1093/med/9780198849353.003.0020","DOIUrl":"https://doi.org/10.1093/med/9780198849353.003.0020","url":null,"abstract":"Cardiac imaging is the cornerstone in the diagnosis of endocarditis. It plays a key role in the confirmation of the diagnosis, location, and extension of the disease, as well as on the evaluation of associated lesions that directly impact treatment options. Echocardiography, both transthoracic and transoesophageal, are the main tools in the diagnostic process. However, alternative imaging techniques have emerged to compensate some of their pitfalls. In this chapter, we review the potential findings as well as the advantages and limitations of each technique. A correct understanding of the information they can provide is essential both for the clinical cardiologist and the specialist in cardiac imaging.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130829329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1093/med/9780198849353.003.0004
J. Bogaert, R. Symons, Jeremy T. Wright
Cardiac magnetic resonance imaging (CMR) has rapidly evolved to become the modality of choice in the evaluation of a wide spectrum of cardiovascular disorders. This is mostly related to its multiparametric approach where the different features such as morphology (including deep tissue characterization), function, perfusion can be non-invasively studied using a series of (different) pulse sequences. Therefore, CMR may provide a ‘one stop shop’ approach to cardiac patients offering a complete cardiac evaluation by a single modality without the use of ionizing radiation. However, to maximize its clinical use, not all pulse sequences should be used in every patient. Moreover, minimizing time spent in the magnetic resonance imaging (MRI) machine is desirable in critically ill, unstable patients. Therefore, experienced cardiac imagers from radiology and cardiology should be present to provide on-site real-time assessment of the images and to determine which pulse sequences are necessary each patient. In this fashion, a complete CMR exam should be obtainable in less than 30 minutes for the vast majority of patients. The aim of this chapter is to describe the physics and practical aspects of CMR and then explore the available pulse sequences, so that the clinical utility of CMR can be maximized.
{"title":"CMR—basic principles","authors":"J. Bogaert, R. Symons, Jeremy T. Wright","doi":"10.1093/med/9780198849353.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780198849353.003.0004","url":null,"abstract":"Cardiac magnetic resonance imaging (CMR) has rapidly evolved to become the modality of choice in the evaluation of a wide spectrum of cardiovascular disorders. This is mostly related to its multiparametric approach where the different features such as morphology (including deep tissue characterization), function, perfusion can be non-invasively studied using a series of (different) pulse sequences. Therefore, CMR may provide a ‘one stop shop’ approach to cardiac patients offering a complete cardiac evaluation by a single modality without the use of ionizing radiation. However, to maximize its clinical use, not all pulse sequences should be used in every patient. Moreover, minimizing time spent in the magnetic resonance imaging (MRI) machine is desirable in critically ill, unstable patients. Therefore, experienced cardiac imagers from radiology and cardiology should be present to provide on-site real-time assessment of the images and to determine which pulse sequences are necessary each patient. In this fashion, a complete CMR exam should be obtainable in less than 30 minutes for the vast majority of patients. The aim of this chapter is to describe the physics and practical aspects of CMR and then explore the available pulse sequences, so that the clinical utility of CMR can be maximized.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122101451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1093/med/9780198849353.003.0003
G. Pontone, Filippo Cademartiri
Computed tomography (CT) was introduced for clinical diagnostic radiology in 1971, and it was used as neuro and body scanner for about 20 years. Spatial and temporal resolution required to evaluate a dynamic structure such as the heart was not sufficient until 1998. Thanks to the technical developments in CT technology over the past 20 years cardiac CT (CCT) developed from an investigative tool into an established clinical tool primarily used as non-invasive clinical diagnostic test for coronary artery imaging. The key technical development occurred in the late 1990s with the introduction of multidetector CT (4 slices) scanners able to synchronize image acquisition and reconstruction with an electrocardiographic (ECG) track. However, 4-slice and also the following 16-slice CT technology had technical limitations, such as limited coverage and temporal resolution, but which allowed diagnostic image quality in selected patients with low and stable heart rate. Moreover, relatively high radiation exposure was required to obtain clinically valid image quality. For this reason, different technical strategies were developed in the following years and advances were also provided in the field of reconstruction algorithm with the introduction of iterative algorithms that allowed an image noise reduction and in the field of tissue characterization with the use of dual-energy CT. All these advances allowed CCT to become a pivotal tool in the cardiology daily practice to image the coronary arteries and beyond.
{"title":"Cardiac CT—basic principles","authors":"G. Pontone, Filippo Cademartiri","doi":"10.1093/med/9780198849353.003.0003","DOIUrl":"https://doi.org/10.1093/med/9780198849353.003.0003","url":null,"abstract":"Computed tomography (CT) was introduced for clinical diagnostic radiology in 1971, and it was used as neuro and body scanner for about 20 years. Spatial and temporal resolution required to evaluate a dynamic structure such as the heart was not sufficient until 1998. Thanks to the technical developments in CT technology over the past 20 years cardiac CT (CCT) developed from an investigative tool into an established clinical tool primarily used as non-invasive clinical diagnostic test for coronary artery imaging. The key technical development occurred in the late 1990s with the introduction of multidetector CT (4 slices) scanners able to synchronize image acquisition and reconstruction with an electrocardiographic (ECG) track. However, 4-slice and also the following 16-slice CT technology had technical limitations, such as limited coverage and temporal resolution, but which allowed diagnostic image quality in selected patients with low and stable heart rate. Moreover, relatively high radiation exposure was required to obtain clinically valid image quality. For this reason, different technical strategies were developed in the following years and advances were also provided in the field of reconstruction algorithm with the introduction of iterative algorithms that allowed an image noise reduction and in the field of tissue characterization with the use of dual-energy CT. All these advances allowed CCT to become a pivotal tool in the cardiology daily practice to image the coronary arteries and beyond.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114230851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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