New Developments in Cardiac Imaging: The Role of MDCT

Journal of Clinical and Basic Cardiology 2001; 4 (4): 253-260

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Keywords: Computertomographie,  Computertomographie-Angiographie,  CTA,  Koronare Herzkrankheit,  MDCT,  CAD,  computed tomography angiography,  coronary artery disease,  CTA,  MDCT,  multidetector-row computed tomography

Recently, mechanical multidetector-row CT (MDCT) systems with simultaneous acquisition of four slices and half-second scanner rotation have become available. Multidetector-row acquisition with these scanners allows considerably faster coverage of the heart volume compared to single-slice scanning. This increased scan speed can be used for retrospective gating together with 1 mm collimated slice widths. This allows coverage of the entire cardiac volume in one breath-hold and provides improved spatial resolution for MDCT angiography of the coronary arteries in comparison to electron beam computed tomography. The gantry rotation speed of 500 ms together with dedicated reconstruction algorithms make a temporal resolution of up to 125 ms feasible. A new imaging protocol using a highly concentrated contrast medium (400 mg/ml) permits depiction of smaller vessels and facilitates post-processing. This new method has the potential to rule out coronary artery disease. Preliminary results from studies in correlation with intracoronary ultrasound suggest that MDCT-technology not only offers the possibility to visualise intracoronary stenoses non-invasively, but also to differentiate plaque morphology.