Computed tomography (CT) images cardiac and adjacent structures and can assess vascular disease, coronary calcification and myocardial perfusion.
Imaging capabilities
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CT can image the cardiac chambers, great vessels, pericardium, mediastinal structures and masses.
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Multidetector scanners can acquire up to 320 slices per rotation, permitting very high-resolution imaging within a single heartbeat.
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A timed injection of X-ray contrast produces clear images of blood vessels and associated pathology.
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Contrast CT is useful for imaging the aorta in suspected aortic dissection and the pulmonary arteries and their branches in suspected pulmonary embolism.
Coronary disease assessment
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Coronary artery calcification can be quantified as a surrogate measure of coronary artery disease burden.
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Modern multidetector CT permits non-invasive coronary angiography with spatial resolution approaching conventional coronary arteriography and a lower radiation dose.
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CT coronary angiography is particularly useful for the initial assessment of chest pain when the likelihood of coronary artery disease is low or intermediate. Its high negative predictive value helps exclude coronary artery disease.
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Modern volume scanners can also assess myocardial perfusion, often during the same examination.