The extent of myocardial death in the setting of myocardial infarction has a substantial impact on the outcome of the patient. Myocardial infarction and its sequelae not only show a major impact on cardiac function and possible subsequent cardiac failure, but also on the risk of inducing severe arrhythmias. MRI of myocardial viability has substantially changed over the last two decades. The evaluation of late gadolinium enhancement LGE techniques has pushed the envelope for the clinical routine assessment of myocardial viability using MR techniques.
Early studies by Kim et al. In early patient studies, the impact of this imaging technique on the prediction of patient outcome after myocardial infarction and revascularisation procedures has been demonstrated [ , ]. LGE imaging offers the ability to assess the transmural extent of residual viability in patients after myocardial infarction. As a major pre-requisite in the use of LGE techniques in myocardial ischaemia, it has to be considered that the extent of myocardial infarction is typically related to coronary artery supply territories and that the development of necrosis starts at the subendocardial level propagating towards the epicardial border over time Fig.
Differentiation of transmural extent of myocardial infarction using late gadolinium enhancement LGE imaging.
Multi-Slice and Dual-Source CT in Cardiac Imaging: Principles - Protocols - Indications - Outlook
While the left image a demonstrates an almost transmural LGE consistent with only minor residual viable tissue, the patient on the right b only suffered from a smaller subendocardial myocardial infarction in the RCA territory. Sequence techniques for assessment of LGE are typically based on inversion recovery IR T1-weighted gradient recalled echo GRE techniques, with additional nulling [optimisation of inversion times TI ] of the normal myocardium [ ]. This approach allows for high differences in signal intensity of viable versus non-viable myocardium. With ongoing technical developments, changes in imaging approaches have been proposed and incorporated into clinical viability imaging.
As segmented data acquisitions in MR rely on constant heart rates and patient cooperation with consistent breath-holding, image quality is substantially reduced in patients with severe arrhythmia or non-cooperative patients. Huber et al. In addition to the elimination of breathing artefacts, this technique can also be used for a substantial shortening of MRI time.
As the image contrast of standard LGE imaging techniques relies on optimal TI settings, this approach is substantially operator-dependent. The use of advanced image calculation and processing techniques, as proposed by Kellman et al. With regard to the volumetric accuracy of myocardial infarction this approach has been shown to demonstrate constant volumes compared with suboptimal TI settings with changing image contrast [ ].
For LGE imaging, the use of higher magnetic field strength also demonstrates benefits with regard to signal levels. CNR levels viable to non-viable myocardium are typically higher at 3 Tesla although the overall image quality is not necessarily affected by this change [ , ]. Regarding the differentiation of acute versus chronic infarction, the sole application of LGE imaging techniques is limited in its diagnostic use.
Further differentiation can be provided by the additional use of T2-weighted oedema imaging. Although several studies evaluated the degree of MO in acute myocardial infarction using early and late gadolinium enhancement imaging, which technique has the better predictive value in terms of LV remodelling remains somewhat controversial [ — ]. MR and CT imaging are emerging as the most promising complementary imaging techniques in the primary diagnosis of CAD and for coronary atherosclerotic disease detection.
For the detection or exclusion of significant CAD, both cardiac CT—including coronary calcium screening and non-invasive coronary angiography—and cardiac MR, applying stress function and stress perfusion imaging, are becoming widely available and are increasingly being applied in clinical routine. Owing to their high negative predictive value, especially in combining two or more of these applications, the presence of CAD can be excluded with a high probability, if patients are selected correctly.
Bernd J. Corresponding author. This article has been cited by other articles in PMC. Abstract In recent years, technical advances and improvements in cardiac computed tomography CT and cardiac magnetic resonance imaging MRI have provoked increasing interest in the potential clinical role of these techniques in the non-invasive work-up of patients with suspected coronary artery disease CAD and correct patient selection for these emerging imaging techniques.
Introduction In recent years, technical advances and improvements in cardiac computed tomography CT and cardiac magnetic resonance imaging MRI have provoked increasing interest in the potential clinical role of these techniques in the non-invasive work-up of patients with suspected coronary artery disease CAD and correct patient selection for these emerging imaging techniques. CT coronary angiography: luminography and beyond CT coronary angiography: are we there yet?
Open in a separate window.
MRI and CT in the diagnosis of coronary artery disease: indications and applications
CT for coronary plaque imaging The imaging reference standard for the detection and characterisation of coronary artery plaques in patients is intravascular ultrasound IVUS. CT viability und perfusion Assessment of myocardial viability and myocardial perfusion plays a critical role in the evaluation of patients with CAD as patterns of myocardial perfusion are associated with short- and long-term prognosis and the haemodynamic relevance of a coronary artery stenosis [ 28 , 29 ].
CT viability imaging Acute ischaemic changes in the myocardium after coronary arterial occlusion consist of disruption of cell membrane function and integrity and increased permeability of small vessel walls. General considerations in cardiac MRI As emphasised earlier, CAD represents a relatively simple description of a disease that in fact consists of a complex array of different sub-entities, especially with regard to the extent, impact and effect upon the heart and its individual structures.
Recommended for you
Assessment of coronary artery stenoses and myocardial ischaemia Coronary artery MRI Direct assessment of the coronary arteries and assessment of potential coronary artery stenoses are considered the holy grail of cardiac imaging. The use of gadolinium-based contrast agents GBCA further improve CNR, irrespective of whether extracellular or intravascular compounds have been applied [ 68 , 73 , 74 ]. Myocardial perfusion imaging Besides the direct visualisation of coronary artery stenosis, the indirect assessment of possible underlying stenotic CAD can also be rendered by MRI, using myocardial perfusion imaging.
Stress cine MRI While MR perfusion imaging focuses on the direct detection of ischaemia at the myocardial blood supply level, stress cine imaging provides an indirect approach to visualising the potential impact of hypoperfusion and thus impaired myocardial oxygen supply on wall motion [ ]. Assessment of myocardial viability Total or temporary occlusion of a coronary artery may result in temporary ischaemic damage or myocardial death and necrosis in the downstream coronary artery territory.
Conclusions MR and CT imaging are emerging as the most promising complementary imaging techniques in the primary diagnosis of CAD and for coronary atherosclerotic disease detection. References 1. Multidetector computed tomography for the diagnosis of coronary artery disease: a systematic review.
Am J Med. J Am Coll Cardiol. Alkadhi H. Radiation dose of cardiac CT—what is the evidence? Eur Radiol. Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters. Eur J Radiol. Prospective versus retrospective ECG gating for detector CT of the coronary arteries: comparison of image quality and patient radiation dose. Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique.
Adequate image quality with reduced radiation dose in prospectively triggered coronary CTA compared with retrospective techniques. Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance.
Cardiac spiral dual-source CT with high pitch: a feasibility study. High-pitch electrocardiogram-triggered computed tomography of the chest: initial results. Invest Radiol. Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience. Saving dose in Triple-Rule-Out computed tomography examination using a high-pitch dual spiral technique.
Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses: first experience. Methods of plaque quantification and characterization by cardiac computed tomography. J Cardiovasc Comput Tomogr. Prognostic value of multislice computed tomography coronary angiography in patients with known or suspected coronary artery disease. Prognostic value of multislice computed tomography and gated single-photon emission computed tomography in patients with suspected coronary artery disease.
Accuracy of slice computed tomography to classify and quantify plaque volumes in the proximal coronary system: a comparative study using intravascular ultrasound. Effect of reader experience on variability, evaluation time and accuracy of coronary plaque detection with computed tomography coronary angiography. Prediction rules for the detection of coronary artery plaques: evidence from cardiac CT. Ex vivo coronary atherosclerotic plaque characterization with multi-detector-row CT.
Multidetector-row computed tomography and magnetic resonance imaging of atherosclerotic lesions in human ex vivo coronary arteries. Influence of intracoronary attenuation on coronary plaque measurements using multislice computed tomography: observations in an ex vivo model of coronary computed tomography angiography.
Influence of convolution filtering on coronary plaque attenuation values: observations in an ex vivo model of multislice computed tomography coronary angiography. The napkin-ring sign: CT signature of high-risk coronary plaques? Noninvasive detection of macrophages using a nanoparticulate contrast agent for computed tomography.
Nat Med. Identification of extensive coronary artery disease in women by exercise single-photon emission computed tomographic SPECT thallium imaging. Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American heart association committee on cardiovascular imaging and intervention, council on cardiovascular radiology and intervention, and committee on cardiac imaging, council on clinical cardiology. Quantitative assessment of myocardial enhancement with iodinated contrast medium in patients with ischemic heart disease by using ultrafast x-ray computed tomography.
Computed tomography assessment of myocardial perfusion, viability, and function. J Magn Reson Imaging. Role of iodinated contrast material in the evaluation of myocardial infarction by computerized transmission tomography. Differential accumulation of radiopaque contrast material in acute myocardial infarction. Am J Cardiol. Magnetic resonance perfusion measurements for the noninvasive detection of coronary artery disease.
Dynamic multi-section CT imaging in acute myocardial infarction: preliminary animal experience. Assessment of myocardial perfusion and viability from routine contrast-enhanced detector-row computed tomography of the heart: preliminary results. In vivo evaluation of experimental myocardial infarcts by ungated computed tomography.
In vivo estimation of myocardial infarct size and left ventricular function by prospectively gated computerized transmission tomography. Myocardial infarct size determined by computed transmission tomography in canine infarcts of various ages and in the presence of coronary reperfusion. Measurement of myocardial infarct size by electron beam computed tomography: a comparison with 99mTc sestamibi. Conventional and ultrafast computed tomography in the detection of viable versus infarcted myocardium.
Am J Card Imaging. Ultrafast computed tomography for the physiological evaluation of myocardial perfusion. Four-dimensional cardiac imaging with multislice computed tomography. Multislice spiral computed tomography of subacute myocardial infarction. Reproducibility of chronic infarct size measurement by contrast-enhanced magnetic resonance imaging. Late-phase MSCT in the different stages of myocardial infarction: animal experiments.
Comparison of slice computed tomography planimetry and Doppler echocardiography in the assessment of aortic valve stenosis. J Heart Valve Dis. Low tube voltage improves computed tomography imaging of delayed myocardial contrast enhancement in an experimental acute myocardial infarction model. Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using section multidetector CT.
Assessment of myocardial edema by computed tomography in myocardial infarction. Validation of minimally invasive measurement of myocardial perfusion using electron beam computed tomography and application in human volunteers. Measurement of regional myocardial blood flow in dogs by ultrafast CT.
Measurement of in vivo myocardial microcirculatory function with electron beam CT. J Comput Assist Tomogr.
Evaluation of porcine myocardial microvascular permeability and fractional vascular volume using slice helical computed tomography CT Invest Radiol. Quantification of myocardial perfusion using dynamic detector computed tomography. CT coronary angiography: slice and detector row scanners.
Curr Cardiol Rep. Dynamic myocardial stress perfusion imaging using fast dual-source CT with alternating table positions: initial experience. Estimated radiation dose associated with cardiac CT angiography. Radiation dose to patients from cardiac diagnostic imaging. Coronary arteries: breath-hold MR angiography. A preliminary report comparing magnetic resonance coronary angiography with conventional angiography.
N Engl J Med. Comparison of 3D free-breathing coronary MR angiography and MDCT angiography for detection of coronary stenosis in patients with high calcium scores. Navigator echo-based respiratory gating for 3D-MR coronary angiography: Reduction of scan time using a slice-interpolation technique. Coronary artery magnetic resonance angiography MRA : a comparison between the whole-heart and volume-targeted methods using a T2-prepared SSFP sequence.
- Poster session II | European Heart Journal - Cardiovascular Imaging | Oxford Academic.
- Multi-slice and dual-source CT in cardiac imaging. Principles..|INIS;
- Electric Relays: Principles and Applications (Electrical and Computer Engineering).
- Account Options.
J Cardiovasc Magn Reson. A respiratory self-gating technique with 3D-translation compensation for free-breathing whole-heart coronary MRA. Magn Reson Med. Volume-targeted and whole-heart coronary magnetic resonance angiography using an intravascular contrast agent. Coronary magnetic resonance angiography for the detection of coronary stenoses. Meta-analysis: noninvasive coronary angiography using computed tomography versus magnetic resonance imaging.
Ann Intern Med. Navigator-gated coronary magnetic resonance angiography using steady-state-free-precession: comparison to standard T2-prepared gradient-echo and spiral imaging. Free-breathing, three-dimensional coronary artery magnetic resonance angiography: comparison of sequences. Whole-heart coronary magnetic resonance angiography at 3 Tesla in 5 minutes with slow infusion of Gd-BOPTA, a high-relaxivity clinical contrast agent. Contrast-enhanced whole-heart MR coronary angiography at 3. Contrast-enhanced whole-heart coronary magnetic resonance angiography at 3. Influence of applying nitroglycerin in whole-heart free-breathing 3D coronary MR angiography.
Noninvasive assessment of coronary vasodilation using magnetic resonance angiography. Screening for proximal coronary artery anomalies with 3-dimensional MR coronary angiography. Int J Cardiovasc Imaging. Magnetic resonance cardiac perfusion imaging - a clinical perspective. Wilson RF.
Assessing the severity of coronary-artery stenoses. J Nucl Cardiol. Myocardial perfusion reserve: assessment with multisection, quantitative, first-pass MR imaging. Contrast-enhanced first pass myocardial perfusion imaging: correlation between myocardial blood flow in dogs at rest and during hyperemia.
Diagnostic performance of stress cardiac magnetic resonance imaging in the detection of coronary artery disease: a meta-analysis. Assessment of advanced coronary artery disease: advantages of quantitative cardiac magnetic resonance perfusion analysis. Assessment of myocardial perfusion in coronary artery disease by magnetic resonance: a comparison with positron emission tomography and coronary angiography.
Assessment of intermediate severity coronary lesions in the catheterization laboratory. Eur Heart J. Cardiac magnetic resonance perfusion imaging for the functional assessment of coronary artery disease: a comparison with coronary angiography and fractional flow reserve. Validation of magnetic resonance myocardial perfusion imaging with fractional flow reserve for the detection of significant coronary heart disease.
- Philosophy and Organization!
- Stochastic Processes and Applications to Mathematical Finance: Proceedings of the 6th International Symposium, Ritsumeikan University, Japan, 6-10 March 2006.
- ISBN 13: 9783540255239.
- Cephalopods: Ecology and Fisheries?
Quantitative magnetic resonance perfusion imaging detects anatomic and physiologic coronary artery disease as measured by coronary angiography and fractional flow reserve. Myocardial first pass perfusion imaging with gadobutrol: impact of parallel imaging algorithms on image quality and signal behavior.
Coronary CT angiography: Dose reduction strategies
Myocardial perfusion imaging with gadobutrol: a comparison between 3 and 1. First-pass myocardial perfusion cardiovascular magnetic resonance at 3 Tesla. Cardiovascular magnetic resonance perfusion imaging at 3-tesla for the detection of coronary artery disease: a comparison with 1. On the dark rim artifact in dynamic contrast-enhanced MRI myocardial perfusion studies. MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial.
Roles of myocardial blood volume and flow in coronary artery disease: an experimental MRI study at rest and during hyperemia. Myocardial blood volume is associated with myocardial oxygen consumption: an experimental study with cardiac magnetic resonance in a canine model. Assessment of regional myocardial oxygenation changes in the presence of coronary artery stenosis with balanced SSFP imaging at 3.
Cardiac stress MR imaging with dobutamine. Noninvasive diagnosis of ischemia-induced wall motion abnormalities with the use of high-dose dobutamine stress MRI: comparison with dobutamine stress echocardiography. Recovery of contractility of viable myocardium during inotropic stimulation is not dependent on an increase of myocardial blood flow in the absence of collateral filling.
Detection of myocardial viability by low-dose dobutamine Cine MR imaging. Magn Reson Imaging. Myocardial Gd-DTPA kinetics determine MRI contrast enhancement and reflect the extent and severity of myocardial injury after acute reperfused infarction. Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction.
Nonstress delayed-enhancement magnetic resonance imaging of the myocardium predicts improvement of function after revascularization for chronic ischemic heart disease with left ventricular dysfunction. Am Heart J. Consequences of brief ischemia: stunning, preconditioning, and their clinical implications: part 1.
An improved MR imaging technique for the visualization of myocardial infarction. Phase-sensitive inversion recovery for detecting myocardial infarction using gadolinium-delayed hyperenhancement. Phase-sensitive inversion-recovery MR imaging in the detection of myocardial infarction. Intraindividual comparison of myocardial delayed enhancement MR imaging using gadobenate dimeglumine at 1.
Cardiovascular magnetic resonance of acute myocardial infarction at a very early stage. Assessment of myocardial viability by cardiovascular magnetic resonance imaging. Microvascular obstruction and left ventricular remodeling early after acute myocardial infarction. Clinical implications of microvascular obstruction and intramyocardial haemorrhage in acute myocardial infarction using cardiovascular magnetic resonance imaging. Predicting late myocardial recovery and outcomes in the early hours of ST-segment elevation myocardial infarction traditional measures compared with microvascular obstruction, salvaged myocardium, and necrosis characteristics by cardiovascular magnetic resonance.
Prognostic value of microvascular damage determined by cardiac magnetic resonance in non ST-segment elevation myocardial infarction: comparison between first-pass and late gadolinium-enhanced images. Articles from Insights into Imaging are provided here courtesy of Springer. How does Europe PMC derive its citations network? Protein Interactions. Protein Families. Nucleotide Sequences. Usefulness of multislice computed tomography for detecting obstructive coronary artery disease. Sun Z, Jiang W. Diagnostic value of multislice computed tomography angiography in coronary artery disease: a meta-analysis.
Diagnostic accuracy of noninvasive coronary angiography using slice spiral computed tomography. Improved diagnostic accuracy with row multi-slice computed tomography coronary angiography. Accuracy of row multidetector computed tomography in detecting coronary artery disease in symptomatic patients: influence of calcification.
American heart journal. Contrast-enhanced coronary artery visualization by dual-source computed tomography--initial experience. Dual-source CT cardiac imaging: initial experience.
- Biochemistry of Oxidative Stress: Physiopathology and Clinical Aspects.
- Related Articles.
- Urgentinė kompiuterinė tomografija | Medas.
- zucipymyno.tk: multislice ct - Cardiology / Internal Medicine: Books.
- Quality-of-Life Research on Children and Adolescents.
- Essential NMR: for Scientists and Engineers.
- Optimal opacification.
Noninvasive coronary angiography by row computed tomography with lower radiation exposure and maintained diagnostic accuracy: comparison of results with cardiac catheterization in a head-to-head pilot investigation. Initial evaluation of coronary images from detector row computed tomography. The international journal of cardiovascular imaging. Sun Z. Biomedical imaging and intervention journal. Sun Z, Ng KH. Multislice CT angiography in cardiac imaging. Part III: radiation risk and dose reduction. Singapore medical journal. Estimated radiation dose associated with cardiac CT angiography.
Use of automatic exposure control in multislice computed tomography of the coronaries: comparison of slice and slice scanner data with conventional coronary angiography. Prospective versus retrospective ECG-gated detector coronary CT angiography: assessment of image quality, stenosis, and radiation dose. Step-and-shoot data acquisition and reconstruction for cardiac x-ray computed tomography. Medical physics. Prospective versus retrospective ECG gating for detector CT of the coronary arteries: comparison of image quality and patient radiation dose. Low-dose adaptive sequential scan for dual-source CT coronary angiography in patients with high heart rate: comparison with retrospective ECG gating.
Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique. Significant coronary artery stenosis: comparison on per-patient and per-vessel or persegment basis at section CT angiography. Diagnostic value of slice multi-detector row cardiac CTA in symptomatic patients.
Cardiac imaging by means of electrocardiographically gated multisection spiral CT: initial experience. Multi-slice and dual-source CT in cardiac imaging:principles-protocols-indications-outlook. Springer-Verlag Berlin Heidelberg Almanya. Current concepts in multidetector row CT evaluation of the coronary arteries: principles, techniques, and anatomy. The technical design and performance of ultrafast computed tomography. Radiol Clin North Am. CT of coronary artery disease. Multidetector-row CT cardiac imaging with 4 and 16 slices for coronary CTA and imaging of atherosclerotic plaques.
Eur Radiol. Coronary arteries: retrospectively ECG-gated multi-detector row CT angiography with selective optimization of the image reconstruction window. Am J Roentgenol. Kalender WA. X-ray computed tomography. Phys Med Biol. CT: the unexpected evolution of an imaging modality. Chasing the heart:new developments for cardiac CT.
J Thorac Imaging. Boyd DP. Radiology of the skull and brain. Technical aspects of computed tomography 5. Mosby St. Louis High speed synchronous volume computed tomography of the heart. Three-dimensional imaging of the heart, lungs, and circulation. Image reconstruction and image quality evaluation for a slice CT scanner with z-flying focal spot. Med Phys. Material differentiation by dual energy CT: initial experience. Invest Radiol. Noninvasive differentiation of uric acid versus non-uric acid kidney stones using dual-energy CT.
Acad Radiol. Dual-energy contrastenhanced computed tomography for the detection of urinary stone disease. Radiology ; Brasewell RN: Strip integration in radioastronomy. Aust J Phys 9: , J Opt Soc Am , Radiology , Cormack AM: Representation of a function by its line integrals with some radiological applications J Appl Phys , Cormack AM: Representation of a function by its line integrals with some radiological applications: II. J Appl Phys , Int Rev. Cytol , Astrophys J , New York, Appleton- Century-Crofts, Simultaneous algebraic reconstruction technique SART : a superior implementation of the art algorithm.
Ultrason Imaging ;6 1 — Algebraic reconstruction techniques ART for threedimensional electron microscopy and x-ray photography. J Theor Biol ;29 3 Gilbert P. Iterative methods for the threedimensional reconstruction of an object from projections. J Theor Biol ;36 1 — Grant K, Flohr T.
Iterative reconstruction in image space IRIS. Published Accessed September Raw data-based iterative reconstruction in body CTA: evaluation of radiation dose saving potential. Eur Radiol ;21 12 — Low-dose CT of the lung: potential value of iterative reconstructions. Eur Radiol ;22 12 : — Grant K, Raupach R. Coronary CT angiography: image quality, diagnostic accuracy, and potential for radiation dose reduction using a novel iterative image reconstruction technique-comparison with traditional filtered back projection.
Eur Radiol ;21 10 — Ultralow-dose chest computed tomography for pulmonary nodule detection: first performance evaluation of single energy scanning with spectral shaping. Invest Radiol ;49 7 : — Adaptive statistical iterative reconstruction:assessment of image noise and image qual ity in coronary CT angiography.
CT coronary angiography: impact of adapted statistical iterative reconstruction ASIR on coronary stenosis and plaque composition analysis. Int J Cardiovasc Imaging ;29 3 : — Acomparison of radiation doses between stateof-the-art multislice CT coronary angiography with iterative reconstruction, multislice CT coronary angiography with standard filtered back-projection and invasive diagnostic coronary angiography. Heart ;96 12 — Eur J Radiol ;81 12 — Int J Cardiovasc Imaging ;28 7 : — Iterative image reconstruction techniques: applications for cardiac CT.