Multi-Slice CT in Cardiac Imaging : Technical Principles, Clinical Application and Future Developments

by Ohnesorge, Bernd M.

• ISBN13: 9783540429661
• ISBN10: 3540429662
• Format: Paperback
• Copyright: 2002-06-01
• Publisher: Springer Verlag

Summary

Cardiac diseases and in particular coronary artery disease are the leading cause of death and morbidity in the industrialized countries. The development of reliable cardiac imaging techniques is considered a key issue in improving patient care. The introduction of multi-slice computed tomography in 1998 represented a breakthrough of CT technology in cardiac imaging. For the first time, widely available CT systems can be used for non-invasive, angiographic assessment of the heart and the coronary arteries. This book presents and discusses the technical concepts, the potential spectrum of applications and the future perspectives of multi-slice CT in cardiac imaging based on the experience of internationally leading clinical institutions. It shows that this new modality has the potential to become an important and robust tool for non-invasive and early diagnosis of cardiac diseases, thus complementing invasive and non-invasive imaging modalities in clinical routine in the near future.

Table of Contents

Motivation	1	(2)
Introduction	3	(12)
Clinical Goals of CT Imaging in the Diagnosis of Cardiac Disease	3	(3)
Coronary Artery Disease	3	(2)
Other Cardiac Diseases	5	(1)
Diseases of the Thoracic Vessels	6	(1)
Established Modalities in Cardiac Imaging	6	(3)
Invasive Imaging	6	(1)
Non-invasive Imaging	6	(3)
The Evolution of Mechanical CT and Electron Beam CT in Cardiac Imaging	9	(6)
Principles and Applications of Electron Beam CT	9	(2)
Cardiac Imaging with Conventional Mechanical CT	11	(4)
Overview of Multi-slice CT Technology	15	(8)
Basis and Motivation of Multi-slice Spiral CT	15	(1)
Multi-slice CT System Design	16	(2)
Multi-slice Spiral Acquisition and Reconstruction for General Purpose Imaging	18	(2)
Image Visualization and Post-processing Techniques for Multi-slice CT in General Cardiovascular Applications	20	(3)
Technical Principles of Cardiac Image Acquisition	23	(38)
Basic Performance Requirements for CT Imaging of the Heart	23	(1)
Prospective Multi-slice ECG Triggering	24	(5)
Half-Scan Image Reconstruction for Optimized Temporal Resolution	24	(3)
ECG-Triggered Partial-Scan Acquisition	27	(2)
Retrospective Multi-slice ECG Gating	29	(19)
Multi-slice Cardiac Volume Reconstruction	29	(4)
ECG-Gated Multi-slice Sprial Acquisition	33	(3)
Segmented Adaptive Cardiac Volume Reconstruction	36	(11)
Advantages and Trade-Offs of ECG Gating vs ECG Triggering	47	(1)
ECG Synchronization Strategies	48	(1)
ECG-Gated Spiral Imaging with Increased Volume Speed	49	(2)
Clinical Examination Protocols	51	(2)
Radiation Exposure Estimation and Reduction Approaches	53	(8)
ECG-Controlled Tube Output Modulation	53	(4)
Edge-Preserving Image Filtering	57	(1)
Scanning with Low kV	58	(3)
Clinical Application and Evaluation	61	(36)
Quantification of Coronary Artery Calcification	61	(14)
Clinical Background and Requirements	61	(1)
Standard Acquisition Protocols	61	(1)
Quantification Methods	61	(3)
Comprison and Correlation of Multi-slice CT and Electron Beam CT	64	(1)
Reproducibility with ECG-Gated Spiral Acquisition	65	(9)
Future Directions	74	(1)
CT-Angiographic Cardiac Volume Imaging and Diagnosis of CAD	75	(14)
Non-invasive Detection and Assessment of Coronary Artery Stenosis	75	(8)
Detection and Evaluation of Atherosclerotic Plaques in Different Stages	83	(2)
Evaluation of Coronary Bypass Graft Patency	85	(2)
Visualization of Cardiac Morphology	87	(2)
Cardiac Function Imaging	89	(2)
ECG-Synchronized Thoracic Imaging	91	(6)
Thoracic Imaging with Cardiac Scan Techniques	91	(1)
ECG-Gated Spiral Scanning with Extended Volume Coverage	92	(2)
Imaging of Pediatric Congenital Heart and Thoracic Vessel Diseases	94	(3)
Future Technical Developments	97	(14)
Limitations in Clinical Application with State-of-the-Art Technology	97	(1)
Future Acquisition Platforms and Reconstruction Methods	98	(8)
Isotropic Cardiac Volume Scanning	98	(4)
Approaches to Improve Temporal Resolution	102	(4)
New Approaches in Evaluation and Quantification	106	(2)
Combined Approaches in Cardiac Imaging and Interventions	108	(3)
Summary and Conclusion	111	(2)
References	113	(6)
Subject Index	119