Ct Cardiac Imaging

CT, with most of the available validation and clinical data being derived from studies of electron beam tomography (EBT), is a robust methodology to evaluate coronary anatomy, vessel patency, atherosclerotic burden and ejection fraction both pre- and post-infarction.

EBT is a fourth generation CT imaging process, able to obtain thin slices of the heart and coronary arteries to evaluate anatomy. Rapid image acquisition due to the absence of a moving x-ray source allows approximately five times greater imaging speed than conventional multislice computed tomography (MSCT), limiting the respiratory and cardiac motion artifacts inherent in cardiac imaging. Usually 30-40 axial images are obtained to include the full-length of the myocardium.

The cine (or movie) scanning mode is designed to assess cardiac function. The scanning frequency of 17 scans/sec is sufficient to study both systolic and diastolic function. The spatial resolution adequately defines the endocardium of both the right and left ventricles so that precise measurements of cardiac volumes, mass and ejection fractions are feasible. Quantitative measurement of wall motion and wall thickening can be performed; it is particularly useful for evaluating CAD patients. Bicycle exercise can be coupled with EBT scanning to detect exercise-induced ischemia. Data indicates that exercise CT may be at least as sensitive and more specific than technetium 99m sestamibi stress testing.

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