الفهرس 
Anatomy of the Coronary Arteries by Multidetector ctOnly 14 pages are availabe for public view
 |  | from | 115 |  |  |
| | | from | 115 | | |
Abstract
Computed tomography (CT) has been embraced as the premier non-invasive modality for vascular imaging of the thorax, however has always been challenging because of the heart’s continuous motion.
CT imaging of the heart moved into the diagnostic land with the introduction of multi-detector row CT and with the development of electrocardiography (ECG)-synchronized scanning and reconstruction techniques. These modalities permit fast volume coverage and high spatial and temporal resolution, which play an important role for successful cardiac imaging.
The central rationale of this application has been the non-invasive detection and grading of coronary artery stenosis. CT is a viable non-invasive modality for delineating coronary arterial anomalies, particularly if findings at coronary angiography are equivocal.
Noninvasive imaging of the coronary arteries using multidetector CT (MDCT) represents one of the most promising diagnostic imaging advances in contemporary cardiology. This challenging application has driven a rapid and impressive advancement in CT technology over the past 10 years; leading to increased spatial and temporal resolution, decreased scan times and substantial reductions in radiation dose. Recent technological improvements have not only improved the status of CT coronary angiography but have also enabled new functional myocardial applications that are gaining a foothold in clinical practice as adjuncts or replacements for conventional coronary angiographic studies. Wide-detector CT designs along with prospective ECG-triggered protocols have opened the possibility of performing multiple complementary myocardial measurements during a coronary CT exam with acceptable radiation and contrast exposure.
While the diagnostic accuracy of coronary CTA in non-stented vessels has reached the stage of clinical applicability, the use of multi-slice CT after coronary intervention with stent placement is still challenging.
With 16-slice CT scanners, assessment is restricted to determining stent patency and total stent occlusion; however, the recent 64-slice CT scanners holds promise to enable significant stenosis of stented coronary segments to be reliably excluded (Nieman K, et al 2007).
There is excellent diagnostic quality of multi-slice CT technology when applied to the follow-up and evaluation of CABG treatment in symptomatic CAD patients.
Multi-slice CT facilitates imaging of both graft and native vessels with unheralded detail, thereby allowing confident evaluation and diagnosis, which ultimately will lead to more successful long-term disease management (Küttner and Kopp, 2007).
The accuracy of CT angiography to detect obstructive graft disease is almost 100%.Comprehensive post-bypass surgery evaluation should also include the assessment of the native coronary arteries, which may prove challenging as a result of advanced, diffuse coronary artery disease (De Feyter & Krestin, 2008).