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British Journal of Radiology (2004) 77, S87-S97
© 2004 British Institute of Radiology
doi: 10.1259/bjr/30634988
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Multislice CT in cardiac and coronary angiography

A F Kopp, MD 1 A Küttner, MD 1 T Trabold, MD 1 M Heuschmid, MD 1 S Schröder, MD 2 and C D Claussen, MD 1

Departments of 1 Diagnostic Radiology and 2 Internal Medicine, Division of Cardiology, Eberhard-Karls-University Tuebingen, Germany



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  		Figure 1. Multidetector-row CT angiography with 4-row technology (collimation 4 x 1 mm, pitch 1.5, 120 ml Imeron® 400). (a) Anterior view of left coronary artery with left anterior descending (LAD) artery in volume rendering technique. (b) Lateral view of left coronary artery with LAD artery and circumflex branch. (c) Maximum intensity projection of right coronary artery (RCA) with calcified plaques (arrow). (d) Diaphragmatic surface with posterolateral and interventricular branches of RCA (arrows).

 


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  		Figure 2. Non-calcified, soft, lipid-rich plaque in left anterior descending artery (arrow) (Somatom Sensation 4, 120 ml Imeron® 400). The plaque was confirmed at intracoronary ultrasound.

 


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  		Figure 3. Adaptive array detector used in the Siemens Somatom Sensation 16. Left: schematic drawing. By proper combination of the signals of the 24 detector rows, the basic collimations 16 x 0.75 mm and 16 x 1.5 mm can be realized. Right: picture of a detector module, which consists of 16 x 24 detector elements.

 


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  		Figure 4. 66-year-old male patient with known single vessel coronary artery disease. (a) Multidetector-row CT angiography of the right coronary artery with a 16-row CT scanner (Somatom Sensation 16, 80 ml Imeron® 400). Even subsegmental branches (arrows) can be readily delineated. (b) Multiplanar reconstruction in the long axis depicts aneurysm of left ventricle s/p myocardial infarction.

 


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  		Figure 5. 59-year old patient with known wall changes in proximal left anterior descending artery without significant obstruction. (a,b) The entire coronary tree is well visualized. Excellent image quality of the displayed coronary tree with only moderate calcifications present (Agatston score 257). (c) Visualization of the entire right coronary artery up to the apex. Protocol: collimation 12 x 0.75 mm, pitch 0.31.

 


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  		Figure 6. 58-year-old male patient with two vessel disease (16-row coronary multidetector-row CT angiography). Note the excellent image quality as well as the absence of calcifications at the site of obstruction. High grade ostial lesion (a) and a tandem lesion in the proximal circumflex artery (b) are to be seen.

 


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  		Figure 7. Multiplanar reconstructions along the left anterior descending artery in a patient who presented for stent patency control and refused coronary catheterization, obtained on a SOMATOM Sensation 16. Rotation time 0.42 s, basic collimation 0.75 mm, reconstructed slice width 3 mm (a), 1.5 mm (b) and 0.75 mm (c).

 


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  		Figure 8. Minimum width dose profiles for a 16-slice CT system and a corresponding 4-slice CT system with equal collimated width of one detector slice. The relative contribution of the penumbra region, which represents wasted dose, decreases with increasing number of simultaneously acquired slices.

 


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  		Figure 9. Temporal resolution (in ms) for 0.42 s and 0.5 s rotation. Temporal resolution as a function of the heart rate for the ACV approach using 0.5 s resp. 0.42 s gantry rotation time. In addition to the absolute improvement, the temporal resolution shows a different dependence on the patient's heart rate for 0.42 s rotation time, reaching its optimum (105 ms) at 81 bpm. This is clinically important, since without administration of beta blockers the majority of heart rates are in the range 75–85 bpm.

 




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