Low Dose Coronary CTA in Ischemic Disease

For some years now cardiovascular disease has been the leading cause of mortality in western countries. Current state-of-the-art cardiac CT imaging, based on 64-slice systems together with dedicated post-processing images, offers the ability to investigate coronary arteries and cardiac structures in a non-invasive procedure with around a 5-sec. acquisition time. The purpose of this work is to give practical guidelines on cardiac CT imaging and especially coronary artery imaging based on the author's daily clinical practice. Most recent techniques of acquisition based on non-helical protocols showing a real dose reduction are presented and discussed. The book covers all steps in cardiac CT imaging from patient preparation, acquisition parameters, injection protocols and recommendations, post-processing images. The role of cardiac CT in routine examination workflow, including interaction with cardiologists and cardiac surgeons, is also discussed. Stenosis, aneurysm or plaque studies are presented, based on the clinical experience of more than 2000 examinations a year. Clinical indications are consequently detailed. The book presents also detailed comparison between cardiac CT and other modalities such as ultrasounds, MRI, PET/CT, conventional angiography, in terms of choice for better patient diagnosis and comfort. TOC: Cardiac CT a routine exam today.- Cardiac and coronary artery anatomy and physiology: Anatomical basis. Physiological basis.- How to perform a Cardiac CT exam? Patient preparation. Optimization of the injection protocol. Examination process. Acquisition technique: helical or low dose mode. Image quality and artefacts.- Clinical experience with low dose Cardiac CT.- Interpreting a Cardiac CT exam: Functional assessment by Cardiac CT. Coronary artery analysis by Cardiac CT. Image fusion.- CT coronary angiography: Exploration of the coronary arteries. Plaque imaging with Cardiac CT.- CT coronary angiography after revascularization: Stent imaging. Bypass follow-up. Myocardium study.- Role of Cardiac CT in cardiology: Indications for Cardiac CT. Advantages of Cardiac CT compared to other diagnosis techniques. Interest of Cardiac CT for surgeon. Interest of Cardiac CT for interventional cardiologist.- Future of Cardiac CT.