Multi slice computerized tomography of the heart and coronary arteries

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Habiba Mizouni
Younes Arous
Mohamed Hedhli
Maha Mahmoud
Emna Menif

Abstract

Background: Due to the recent technological progress, multislice computerized tomography (MSCT) allows visualizing the heart and coronary arteries. Multislice computed tomography is non invasive and provides high quality images.Its main limits are arythmia, tachycardia and coronary calcifications. But the main drawback with MSCT is the radiation dose.
Aim : Report of usefuluess and indications of multislice CT scanner.
Methods : Rzview of literature
Results : Although the indications of MSCT did not reach a guideleness level yet, some trends can be stated. The advantages and limitations of MSCT in cardiac exploration are summarized in this article. The indications are mainly based on the excellent negative predictive value of MSCT regarding coronary artery disease. Hence, patients at low to moderate risk of coronary artery disease mostly benefit of the technique. MSCT can be an alternate examination in case of non feasible or non contributive ischemic test. MSCT is highly contributive in the ostial analysis, in detecting abnormal congenital coronary anomalies or in analysing bypass grafts. MSCT remains limited in patients with heavily calcified coronary arteries, and in patients with stented distal arteries.
Conclusion : Multislice CT scanner should not be considered as equivalent to invasive coronary angiography bu it is a additional diagnostic tool.

Keywords:

Multislice computerized tomography, Coronary arteries, Heart, Coronary artery disease

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References

  1. Rodenwaldt J. Multislice computed tomography of the coronary ateries. Eur Radiol 2003;13: 748-57.
  2. Coles DR, Smail MA, Negus IS et al. Comparison of radiation doses from multislice computed tomograpghy coronary angiography and conventional diagnostic angiography. J Am Coll Cardiol 2006; 47:1840-5.
  3. Pernès JM, Sirol M, Chabbert V et al. Les indications actuelles du scanner cardiaque. Arch Cardiovasc Dis 2009(Supp]);1 :13-22.
  4. Sablayrolles JL, Feignoux J, Treutenaere JM. Scanner multicoupe : Posttraitement. In,Vignaux O, Imagerie du c?ur et des artères coronaires. Paris, Flammarion 2008.
  5. Mahabadia AA, Achenbach S, Burghtahler C et al. Safety, Efficacy and indications of ‚-Adrenergic Receptor Blockade to reduce Heart Rate prior to coronary CT Angiography. Radiology 2010;257:614-23.
  6. Lapeyre M, Dongay B, Sauguet A et al. Optimisation du coroscanner : comment améliorer sa performance diagnostique ? Du contrôle de la qualité au contrôle de la dose délivrée. Formation Médicale Continue numéro 13,57èmes Journées Françaises de Radiologie 2009.
  7. Haller S, Kaiser C, Buser P, Bongartz G, Bremerich J. Coronary artery imaging with contrast-enhanced MDCT : extracardiac findings. Am J Roentgenol 2006;187:105-10.
  8. Dacher JN, Bertrand D, Tronc C. Scanner multi-coupe : Limites, artéfacts et optimisation en scanner cardiaque. In, Vignaux O, Imagerie du c?ur et des artères coronaires. Paris, Flammarion 2008.
  9. Leschka S, Scheffel H, Desbiolles L et al. Image quality and reconstruction intervals of dualsource CT coronary angiography: recommandations for ECG pulsing windowing. Invest Radiol 2007;42:543-9.
  10. Raff GL, Gallagher MJ, O'Neil WW, Goldstein JA. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 2005;46:552-7.
  11. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. J Am Coll Cardiol 2010;56:1864-94.