Current Concepts in Multi–Detector Row CT Evaluation of the Coronary Arteries


Harpreet K. Pannu, MD ; Thomas G. Flohr, PhD ; Frank M. Corl, MS ; Elliot K. Fishman, MD

1 From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Md (H.K.P., F.M.C., E.K.F.); and the CT Division, Siemens Medical Solutions, Forchheim, Germany (T.G.F.). Presented as an education exhibit at the 2002 RSNA scientific assembly. Received March 5, 2003; revision requested April 16 and received May 21; accepted May 29. T.G.F. is an employee of Siemens Medical Solutions. E.K.F. is a consultant to the CT Advisory Board. Address correspondence to H.K.P., Department of Radiology, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287.

Cardiac imaging is becoming a practical application of mechanical computed tomography (CT) with the availability of four, eight, and 16 detector row scanners. The role of imaging is progressing from simple determination of the presence of arterial calcifications on nonenhanced scans to demonstration of vascular stenoses on coronary CT angiograms. Optimization of the imaging technique and knowledge of coronary artery anatomy are both important for the development of CT of the heart. Technical factors such as a slow heart rate, a short scanning time, subcentimeter spatial resolution, high temporal resolution, and reconstruction of multiple image data sets at various intervals in the cardiac cycle result in optimal visualization of the coronary arteries. Axial, thin-slab maximum intensity projection, and volume-rendered images are used to display the normal anatomy and anomalies of the coronary arteries. The challenges of CT angiography of the coronary arteries have been partially met and will likely be overcome with continued evolution of the technology.