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Cardiovascular Computed Tomography 

Cardiovascular Computed Tomography
Chapter:
Cardiovascular Computed Tomography
Author(s):

Pim J. de Feyter

, Stephan Achenbach

, and Koen Nieman

DOI:
10.1093/med/9780199566990.003.006
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date: 22 August 2019

Non-contrast-enhanced computed tomography (CT) coronary calcium imaging is predictive of adverse coronary events, independently and beyond that of traditional risk factors, because calcium is a marker of the presence of coronary atherosclerosis.

Contrast-enhanced CT coronary angiography is a reliable non-invasive diagnostic modality to rule out the presence of significant obstructive coronary artery disease in patients with low-to-intermediate pretest risk of CAD and stable heart rhythm. CT-coronary imaging of non-obstructive atherosclerotic disease of the coronary wall offers the opportunity to evaluate early manifestations of coronary atherosclerosis. Severe coronary calcifications and irregular heart rhythm significantly limit the evaluation of CT-coronary images while the relatively high radiation exposure is of concern. CT imaging for pulmonary embolism and acute aortic dissection is highly accurate and may be considered the first-choice diagnostic option. CT imaging of great thoracic vessels, for cardiac function, heart valves, cardiac tumours and thrombi, or pericardial disease is feasible but the non-radiation diagnostic modalities echocardiography or cardiac magnetic resonance (CMR) imaging should be considered as first diagnostic options....

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