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Multislice Cardiac CT-Angiography; A Review on Accepted Indications and Potentials for Other Applications Regarding the Newest Development

Author(s): M. Motevalli | A.R. Almasi | A. Sadatnaseri

Journal: Iranian Journal of Radiology
ISSN 1735-1065

Volume: 4;
Issue: S1;
Start page: 12;
Date: 2007;
Original page

There were not any clear-cut criteria available for clinical use of cardiac CT-angiography (CCTA) up to October 2006 in which the American College of Car-diology (ACC), American College of Radiology (ACR) and six other medical institutions released a joint consensus on clinical indications of cardiac CT and MRI. A statement was released by the American Heart Association together with two other radiology and cardiology institutions in the same month on the same matter. An illustrated review will be presented on the newly accepted indications of cardiac CT, especially CCTA. Some prominent indications are as follow: 1. Evaluation of chest pain syndrome in patient with intermediate pretest probability of coronary artery disease (CAD) when exercise test is not feasible. 2. Evaluation of acute chest pain in patient with in-termediate pretest probability of CAD and negative ECG and enzymes. 3. Uninterpretable or equivocal stress test (exercise, perfusion scan, or stress echo). 4. Evaluation of coronary arteries in patients with new onset heart failure. 5. Assessment of congenital coronary and cardiac anomalies. 6. Noninvasive coronary vein mapping prior to placement of biventricular pacemaker. 7. Noninvasive coronary arterial mapping, including internal mammary artery prior to repeat cardiac sur-gical revascularization. Some recent research indicated that CCTA is useful in some other specific situations too, like evaluating in-stent re-stenosis for stainless steel or cobalt stents more than 3mm in diameter and has also some roles in the evaluation of coronary bypass grafts, etc. Fi-nally, the newer progressions in the field of multislice CT are promising of even better performance which may widen the scope of its indications. Dual-source CT scanners have shown better performance com-pared with 64-slice CT scanners in the preliminary studies, namely slice-thickness of 0.25mm vs. 0.4mm, temporal resolution of 83ms vs.165ms, assessable segments of 98.6% vs. 97%, sensitivity in detection of significant stenosis of 96.4% vs. 92% and specificity of 97.5 vs. 94%.
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