Advances in Nonnuclear Imaging Technologies

Journal of Nuclear Cardiology

, Volume 14, Issue 2, pp 229-243

First online:

Comprehensive cardiac CT study: Evaluation of coronary arteries, left ventricular function, and myocardial perfusion—Is it possible?

  • Ricardo C. CuryAffiliated withCardiac MRI-PET-CT Program, Massachusetts General Hospital and Harvard Medical SchoolDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School Email author 
  • , Koen NiemanAffiliated withDepartment of Cardiology, Thorax Centre, Erasmus Medical Center
  • , Michael D. ShapiroAffiliated withCardiac MRI-PET-CT Program, Massachusetts General Hospital and Harvard Medical SchoolDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School
  • , Khurram NasirAffiliated withCardiac MRI-PET-CT Program, Massachusetts General Hospital and Harvard Medical SchoolDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School
  • , Roberto C. CuryAffiliated withDepartment of Cardiology, Heart Institute (InCor), University of Sao Paulo
  • , Thomas J. BradyAffiliated withCardiac MRI-PET-CT Program, Massachusetts General Hospital and Harvard Medical SchoolDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School

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Abstract

With advances in multidetector computed tomography (MDCT) technology, the new generation of 64-slice MDCT scanners with submillimeter collimation and a faster gantry ratation allows imaging of the entire heart in a single breath-hold with excellent temporal and spatial resolution. This potentially permits a comprehensive assessment of coronary anatomy, left ventricular function, and myocardial perfusion. As will be seen in this review of the current literature regarding 16- and 64-slice MDCT, there is great promise for a comprehensive cardiac computed tomography (CT) study. The available data support the notion that CT coronary angiography may be an alternative to invasive coronary angiography in symptomatic patients with a low to intermediate likelihood of having coronary artery disease. By use of the same data acquired for CT coronary angiography, evaluation of global and regional left ventricular function and myocardial perfusion can be added to the MDCT evaluation without additional exposure to contrast medium or radiation and may provide a more conclusive cardiac workup in these patients. The potential applications and limitations of coronary stenosis detection, global and regional left ventricular function, and myocardial perfusion assessment by MDCT will be reviewed. The full potential of cardiac MDCT is just beginning to be realized.