Cardiovascular CT for perfusion and delayed contrast enhancement imaging

Ravi K. Sharma, Ilan Gottlieb, Joao Lima

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Recent advancements in multi-detector computed tomography (MDCT) imaging have demonstrated the ability of MDCT to be a comprehensive imaging modality, which in a single scan setting could provide a wide array of complementary information. Advent of MDCT system with faster scan acquisition of entire myocardial volume has allowed assessment of stress myocardial perfusion that has shown to provide incremental diagnostic accuracy over coronary CT angiography (CTA) in assessing hemodynamically significant stenosis. Detection of fibrosis by Delayed Enhanced MDCT (DE-MDCT) has been validated against gold standards such as histology and contrast enhanced MRI. DE-MDCT can accurately identify and characterize morphological features of acute and healed myocardial infarction, including infarct size, transmurality, and the presence of microvascular obstruction and collagenous scar. In addition, recent studies have also substantiated the utility of contrast enhanced MDCT in assessment of extracellular volume fraction (ECV) which corresponds to diffuse myocardial fibrosis. This has allowed comprehensive evaluation of myocardial tissue characteristics with significant bearing on the management, prognosis and follow- up of a myocardial disease process.

Original languageEnglish (US)
Title of host publicationCardiac CT Imaging: Diagnosis of Cardiovascular Disease
PublisherSpringer International Publishing
Pages211-220
Number of pages10
ISBN (Electronic)9783319282190
ISBN (Print)9783319282176
DOIs
StatePublished - Jan 1 2016

Keywords

  • Computed tomography perfusion
  • Delayed enhanced MDCT
  • MDCT myocardial viability
  • Myocardial fibrosis
  • Stress CT perfusion

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Sharma, R. K., Gottlieb, I., & Lima, J. (2016). Cardiovascular CT for perfusion and delayed contrast enhancement imaging. In Cardiac CT Imaging: Diagnosis of Cardiovascular Disease (pp. 211-220). Springer International Publishing. https://doi.org/10.1007/978-3-319-28219-0_12