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Cardiac computerized tomography (CT)

Authoring team

  • Cardiac Computed Tomography (CT)
    • cardiac CT uses x-rays to build up 3D images of the heart
    • CT imaging of the heart can be performed either with or without intravenous contrast agents
    • as with cardiac magnetic resonance (CMR), following acquisition, the CT datasets can be reformatted in any orientation and can be viewed as cine loops for functional analysis of ventricular function
    • software allows semi-automated extraction of the coronary arteries and the production of 3D volumetric datasets
    • total scan time for a cardiac CT is about 15 minutes

Notes:

  • CT provides rapid, high quality imaging of the coronary arteries not matched by any other non-invasive technique and is the only technique able to provide a coronary artery calcium score (CACS)
    • presence of coronary artery calcium is associated with plaque burden - however, it is not a marker of plaque vulnerability
      • despite this limitation the CACS gives an insight to the patient's level of cardiovascular disease risk and is helpful for guiding interventions or prevent coronary artery disease (2,3)

      • ACC/AHA guidelines on assessment of cardiovascular risk state that assessment of CACS may be considered based on a large number of observational studies:
        • with a CACS of >=300 Agatston units (or >=75th percentile for age, sex and ethnicity) supporting an upward revision in risk assessment (4)

  • CT scanning is less claustrophobic than MRI and can be used in most patients who are precluded from having CMR

Reference:


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