cardiac CT uses x-rays to build up 3D images of the heart
CT imaging of the heart can be performed either with or without intravenous contrast agents
as with cardiac magnetic resonance (CMR), following acquisition, the CT datasets can be reformatted in any orientation and can be viewed as cine loops for functional analysis of ventricular function
software allows semi-automated extraction of the coronary arteries and the production of 3D volumetric datasets
total scan time for a cardiac CT is about 15 minutes
Notes:
CT provides rapid, high quality imaging of the coronary arteries not matched by any other non-invasive technique and is the only technique able to provide a coronary artery calcium score (CACS)
presence of coronary artery calcium is associated with plaque burden - however, it is not a marker of plaque vulnerability
despite this limitation the CACS gives an insight to the patient's level of cardiovascular disease risk and is helpful for guiding interventions or prevent coronary artery disease (2,3)
ACC/AHA guidelines on assessment of cardiovascular risk state that assessment of CACS may be considered based on a large number of observational studies:
with a CACS of >=300 Agatston units (or >=75th percentile for age, sex and ethnicity) supporting an upward revision in risk assessment (4)
CT scanning is less claustrophobic than MRI and can be used in most patients who are precluded from having CMR
Goff DCet al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:2935-2959
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