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Cardiac CT
Marc Dewey
Cardiac CT
Second Edition
Marc Dewey , Prof. Dr. med. Charité – Universitätsmedizin BerlinHeisenberg Professor of Radiology Institut für Radiologie Charitéplatz 1 10117 Berlin Germany e-mail: [email protected]
ISBN 978-3-642-41882-2 ISBN 978-3-642-41883-9 (eBook) DOI 10.1007/978-3-642-41883-9 Springer Heidelberg New York Dordrecht London
Library of Congress Control Number: 2014936307
© Springer-Verlag Berlin Heidelberg 2011, 2014
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Computed tomography (CT) has been going through a dramatic evolution of technology in the past years. Cardiac CT has become reliably possible and benefi ts to a large extent from the continuous development. Th e technical advances directly translate into improved image quality, lower radiation exposure, and more versa-tile applications. CT angiography of the coronary arter-ies – oft en referred to as coronary CT angiography – has received tremendous interest and is now an established clinical tool in selected patients. In fact, it has the poten-tial to greatly alter the way in which many patients with suspected coronary artery disease will be worked up. However, the technique requires special knowledge and experience and it is important to keep abreast with the
newest developments, protocols, technology, and clinical results in order to optimally apply this diagnostic tool.
Th is is why the second edition of this textbook edited by Dr. Dewey is just as welcome as the fi rst edition in 2011. It provides insight into the basics of cardiac CT and at the same time includes all relevant new develop-ments. May it be a useful resource to its readers and may it contribute towards the further development of this exciting fi eld.
Erlangen, Germany Stephan Achenbach Baltimore, MD, USA Elliot K. Fishman August 2013
Foreword
Acknowledgments
Together with my team I would like to thank our patients, without whom we would not be able to conduct our clin-ical work and studies to continuously increase our understanding of the clinical utility of cardiac CT.
We are indebted to our technicians, assistants, and nurses at the Department of Radiology of the Charité – Universitätsmedizin Berlin for their contributions to the success of our clinical cardiovascular imaging program. Without their support, this book would not have been possible. Th e editorial assistance of Bettina Herwig and Deborah McClellan has been instrumental in writing this book. Stephanie Kreutzer has created beautiful art-work to illustrate essential concepts and approaches.
Th e excellent collaboration with the Department of Cardiology and Angiology at the Charité (Chairman:
Prof. Gert Baumann, Vice Chairman: Prof. Karl Stangl) has tremendously facilitated this work. We thank Prof. Wolfgang Rutsch (former head of the cardiac catheter-ization laboratory at the Charité Campus Mitte) and his successor Dr. Michael Laule as well as their coworkers Dr. Adrian Borges, Dr. Hans-Peter Dübel, Dr. Christoph Melzer, Prof. Verena Stangl, and Prof. Heinz Th eres for providing the majority of the conventional invasive angiograms presented in this book.
I wholeheartedly thank Drs. Martina and Charles Dewey.
Berlin, Germany Marc Dewey August 2013
Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . 1B. Hamm
2 Technical and Personnel Requirements. . . . . 3M. Dewey
3 Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . 13M. Dewey and L.J.M. Kroft
4 Cardiac CT in Clinical Practice . . . . . . . . . . . 29K. Nieman
5 Clinical Indications. . . . . . . . . . . . . . . . . . . . 39M. Dewey
6 Patient Preparation. . . . . . . . . . . . . . . . . . . . 49M. Dewey
7 Physics Background and Radiation Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . 55J. Geleijns and M. Dewey
8 Examination and Reconstruction . . . . . . . . . 69M. Dewey
9a Toshiba Aquilion 64 and Aquilion ONE. . . . . 91E. Zimmermann
9b Siemens Somatom Sensation, Defi nition, and Defi nition Flash . . . . . . . . . . 109H.-C. Becker, C. Klessen, and K. Anders
9c Philips Brilliance 64 and iCT. . . . . . . . . . . . . 125O. Klass, M. Jeltsch, and M.K. Hoffmann
9d General Electric LightSpeed VCT, Optima CT660 and Discovery CT750 HD . . . . . . . . . . 133L. Lehmkuhl, E. Martuscelli, and M. Jinzaki
10 Reading and Reporting . . . . . . . . . . . . . . . . . 151L.J.M. Kroft and M. Dewey
11 Coronary Artery Calcium . . . . . . . . . . . . . . . 181M.A. Latif, M.J. Budoff, and P. Greenland
12 Coronary Artery Bypass Graft s . . . . . . . . . . . 191E. Martuscelli
13 Coronary Artery Stents . . . . . . . . . . . . . . . . . 199K. Anders
14 Coronary Artery Plaque . . . . . . . . . . . . . . . . 213P. Schoenhagen, H. Niinuma, T. Gerber, and M. Dewey
15 Cardiac Function . . . . . . . . . . . . . . . . . . . . . 225F. Wolf and G. Feuchtner
16 Cardiac Valves. . . . . . . . . . . . . . . . . . . . . . . . 243G. Feuchtner
17 Transcatheter Aortic Valve Interventions . . . . . . . . . . . . . . . . . . . . . . . . 259F. Plank, J.N. Dacher, G. Feuchtner, and J. Leipsic
18 Pulmonic Valve Implantation, Mitral Valve Repair, and Left Atrial Appendage Closure . . . . . . . . . . . . . . . . . . . . 285V. Delgado
x
19 Myocardial Perfusion and Fractional Flow Reserve. . . . . . . . . . . . . . . . . . . . . . . . . 303K. Kitagawa, A. Erglis, and M. Dewey
20 Hybrid Imaging . . . . . . . . . . . . . . . . . . . . . . 327O. Gaemperli and P.A. Kaufmann
21 Electrophysiology Interventions . . . . . . . . . . 341R.A. Salgado and B. Ghaye
22 Coronary Artery Anomalies . . . . . . . . . . . . . 367P.G.C. Begemann, M. Grigoryev, G. Lund, G. Adam, and M. Dewey
23 Congenital and Acquired Heart Disease . . . . 393S. Ley, B.K. Han, R. Arnold, and J.R. Lesser
24 Typical Clinical Examples . . . . . . . . . . . . . . . 415M. Dewey
25 Results of Clinical Studies . . . . . . . . . . . . . . . 483M. Dewey
26 Outlook . . . . . . . . . . . . . . . . . . . . . . . . . . . 487M. Dewey
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 495
Contents
Contributors
Editor Marc Dewey , Prof. Dr. med. Institut für Radiologie , Charité – Universitätsmedizin Berlin , Charitéplatz 1 , 10117 Berlin , Germany [email protected]
Contributors Gerhard Adam , Prof. Dr. med. Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie , Universitätsklinikum Hamburg-Eppendorf, Diagnostikzentrum , 20246 Hamburg , Germany [email protected]
Katharina Anders , Priv.-Doz. Dr. med. Radiologisches Institut, Universitätsklinikum Erlangen , Maximiliansplatz 1 , 91054 Erlangen , Germany [email protected]
Raoul Arnold , Dr. med. Klinik III: Angeborene Herzfehler/Pädiatrische Kardiologie, Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Freiburg , Mathildenstr. 1 , 79106 Freiburg , Germany [email protected]
Hans-Christoph Becker , Prof. Dr. med. Institut für Klinische Radiologie, Klinikum der Universität München , Marchioninistraße 15 , 81377 Munich , Germany [email protected]
Philipp G. C. Begemann , Priv.-Doz. Dr. med. Röntgeninstitut Düsseldorf , Kaiserswerther Strasse 89 , 40476 Düsseldorf , Germany [email protected]
Matthew J. Budoff , MD Los Angeles Biomedical Research Institute , 1124 W Carson Street , 90502 Torrance , CA , USA mbudoff @labiomed.org
Jean Nicolas Dacher , Prof. Département d’Imagerie Médicale , Imagerie Cardiaque non Invasive, University Hospital of Rouen , 1, Rue de Germont , 76031 Rouen , France [email protected]
Victoria Delgado , MD, PhD Department of Cardiology , Leiden University Medical Center , Albinusdreef 2 , 2300 RC Leiden , Th e Netherlands [email protected]
Andrejs Erglis , Prof. MD, PhD Insititute of Cardiology, Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, University of Latvia , Pilsonu 13 , LV1001 Riga , Latvia [email protected]
Gudrun Feuchtner , Ao. Univ.-Prof. Dr. med. Institut für Radiologie II , Medizinische Universität Innsbruck , Anichstr. 35 , A-6020 Innsbruck , Austria [email protected]
Oliver Gaemperli , Priv.-Doz. Dr. med. Andreas Grüntzig Cardiac Catheterization Laboratories and Cardiac Imaging, University Hospital Zurich , Ramistrasse 100 , CH-8091 Zurich , Switzerland [email protected]
Jacob Geleijns , PhD Afdeling Radiologie , Leids Universitair Medisch Centrum , Postbus 9600 , 2300 RC Leiden , Th e Netherlands [email protected]
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Th omas Gerber , MD, PhD Division of Cardiovascular Diseases , Mayo Clinic , 4500 San Pablo Road , 32224 Jacksonville , FL , USA [email protected]
Benoît Ghaye , MD Department of Radiology , Cliniques Universitaires St-Luc, Catholic University of Louvain , Brussels , Belgium [email protected]
Philip Greenland , MD Northwestern University Feinberg School of Medicine , 680 North Lake Shore Drive, Suite 1400 , 60611 Chicago , IL , USA [email protected]
Maria Grigoryev , Dr. med. Institut für Radiologie , Charité – Universitätsmedizin Berlin , Charitéplatz 1 , 10117 Berlin , Germany [email protected]
Bernd Hamm , Prof. Dr. med. Institut für Radiologie , Charité – Universitätsmedizin Berlin , Charitéplatz 1 , 10117 Berlin , Germany [email protected]
B. Kelly Han , MD Minneapolis Heart Institute, Th e Children’s Heart Clinic at the Children’s Hospitals and Clinics of Minnesota , Suite 500, 2530 Chicago Ave South , 55404 Minneapolis , MN , USA [email protected]
Martin K. Hoff mann , Prof. Dr. med. Leiter Interventionelle Radiologie , Luzerner Kantonsspital , 6000 Luzern 16 , Luzern , Switzerland martin.hoff [email protected]
Martin Jeltsch , Dr. med. Kliniken der Kreisspitalstift ung Weißenhorn , Weißenhorn , Germany m.jeltsch@stift ungsklinik-weissenhorn.de
Masahiro Jinzaki , Dr. Department of Diagnostic Radiology , Keio University School of Medicine , 35 Shinanomachi, Shinjuku-ku , 160-8582 Tokyo , Japan [email protected]
Philipp A. Kaufmann , Prof. Dr. med. University Hospital Zurich , Ramistrasse 100 , CH-8091 Zurich , Switzerland [email protected]
Kakuya Kitagawa , MD, PhD Department of Radiology , Mie University Hospital , Tsu , Japan [email protected]
Oliver Klass , Priv.-Doz. Dr. med. MediaPark-Klinik , Im Mediapark 3 , 50670 Köln , Germany [email protected]
Christian Klessen , Dr. med. Institut für Radiologie , Charité – Universitätsmedizin Berlin , Charitéplatz 1 , 10117 Berlin , Germany [email protected]
Lucia J.M. Kroft , Dr. Afdeling Radiologie , Leids Universitair Medisch Centrum , Postbus 9600 , 2300 RC Leiden , Th e Netherlands L.J.M.Kroft @lumc.nl
Muhammad A. Latif , MD Stanford University School of Medicine , 800 Welch Road, FC2C51 , 94304 Stanford , CA , USA [email protected]
Lukas Lehmkuhl , Dr. med. Diagnostische und Interventionelle Radiologie , Universität Leipzig – Herzzentrum , Strümpellstrasse 39 , 04289 Leipzig , Germany [email protected]
Jonathon Leipsic , MD Department of Radiology , St. Paul’s Hospital , 1081 Burrard St , V6Z 1Y6 Vancouver , BC , Canada [email protected]
John R. Lesser , MD Minneapolis Heart Institute , 920 E. 28th Street, Suite 300 , 55407 Minneapolis , MN , USA [email protected]
Sebastian Ley , Priv.-Doz. Dr. med. Diagnostische und Interventionelle Radiologie , Chirurgische Klinik Dr. Rinecker , Am Isarkanal 30 , 81379 Berlin , Germany [email protected]
Gunnar Lund , Priv.-Doz. Dr. med. Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie , Universitätsklinikum Hamburg-Eppendorf, Diagnostikzentrum , 20246 Hamburg , Germany [email protected]
Contributors
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Eugenio Martuscelli Department of Internal Medicine, Division of Cardiology , University of Rome “Tor Vergata” , Viale Oxford 81 , 00133 Rome , Italy [email protected]
Koen Nieman , MD, PhD Departments of Cardiology and Radiology , Erasmus Medical Center , Th oraxcenter Bd 116, ‘s-Gravendijkwal , 3015 CE Rotterdam , Th e Netherlands [email protected]
Hiroyuki Niinuma , MD, PhD Memorial Heart Center, Iwate Medical University , 1-2-1 ChuoDori , 020-8505 Morioka , Iwate , Japan [email protected]
Fabian Plank , MD Institut für Radiologie II , Medizinische Universität Innsbruck , Anichstr. 35 , A-6020 Innsbruck , Austria [email protected]
Rodrigo A. Salgado , MD Department of Radiology, Cardiovascular Imaging , Antwerp University Hospital , Wilrijkstraat 10 , 2650 Edegem , Belgium [email protected]
Paul Schoenhagen , MD Division of Radiology, Cardiovascular Imaging and Department of Cardiovascular Medicine , Th e Cleveland Clinic Foundation , Cleveland , USA [email protected]
Florian Wolf , Priv.-Doz. Dr. med. Abteilung für Kardiovaskuläre und Interventionelle Radiologie , Medizinische Universität Wien, Universitätsklinik für Radiodiagnostik , Währinger Gürtel 18-20 , A-1090 Wien , Austria fl [email protected]
Elke Zimmermann , Dr. med. Institut für Radiologie , Charité – Universitätsmedizin Berlin , Charitéplatz 1 , 10117 Berlin , Germany [email protected]
Contributors