March/April 2008

Coming October 2008

Applications of Cardiac CT in the Context of Electrophysiology Interventions

Laurens F. Tops, MD, and Jergen Bax, MD, Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

Acute Chest Pain

Charles S. White, MD, Department of Diagnostic Radiology, University of Maryland Medical Center, Baltimore, MD

Introduction

Stephan Achenbach, MD, FACC, FESC, Department of Cardiology, University of Erlangen, Erlangen, Germany

In the field of cardiac and cardiovascular CT, the necessary expertise is not restricted to one single area of medical practice. Knowledge of radiology, cardiology, and vascular disease is necessary to competently perform and evaluate the CT scan. view article

Top ten clinical indications for coronary CT angiography

Stephan Achenbach, MD, FACC, FESC, Department of Cardiology, University of Erlangen, Erlangen, Germany

Coronary CT Angiography has become a robust imaging techique for visualization of the coronary artery lumen. While the spatial and temporal resolution do not equal that of invasive, catheter-based coronary angiography, the clinical gold standard for imaging the coronary lumen and clinical applications of coronary CT angiography are possible if adequate equipment is used, the investiagtors are sufficiently experienced, and the patients are somewhat selected. The most prominent application is to use this non-invasive technique to reliably rule out coronary artery stenoses in patients in whom the clinical work-up suggests an intermediate likelihood of coronary artery stenoses. With ongoing improvement in imaging equipment and increasing availablility of studies that address the use of coronary CT angiography in specific clinical situations, further applications will be developed and backed by scientific data. view article

Peripheral vascular CTA: Emerging role of PV-CTA in the therapeutic management of PVD

David E. Allie, MD, Raghotham R. Patlola, MD, Chris J. Hebert, RTR, RCIS, and Craig M. Walker, MD, Cardiovascular Institute of the South, Lafayette, LA

Conventional diagnostic angiography remains the clinical gold standard for diagnostic vascular imaging, but has multiple limitations. Peripheral vascular computed tomography angiography (PV-CTA) is increasingly being utilized for non-invasive vascular assessment and has the potential to revolutionize the diagnostic and the therapeutic management of non-cardiac vascular disease. The goals of this review are to discuss the use of PV-CTA in vascular territories from head-to-toe and illustrate several understated therapeutic benefits of PV-CTA that can potentially improve outcomes and optimize the comprehensive therapeutic treatment of PVD. view article

Coronary Artery Involvement in Acute Aortic Dissection with Pseudoaneurysm: Evaluation with Cardiac CT

Jonathan D. Dodd MB, David O’Donnel MB, Ronan Killeen MB, Ronan Ryan MB, Peter Quigley MB, Martin Quinn MB

We report the case of a patient with atypical chest pain and dyspnoea caused by acute aortic dissection complicated by pseudoaneurysm. Contrast-enhanced coronary 64-slice CT (CTA) with images reconstructed using ECG-gating, clearly demonstrated proximal extension of the dissection flap to involve the left main coronary ostium. Such pre-operative information necessitated surgical coronary reimplanation as part of the aortic root and valve repair. CTA is well suited to establish the exact involvement of the aortic root and coronary ostia in patients with aortic dissection. view article