Faculty Bibliography

The multidetector coronary computed tomography angiogram findings of a rare variant crossed left circumflex and left anterior descending artery are presented. In this patient, multidetector coronary computed tomography angiogram enabled clear delineation of the aberrant coronary artery anatomy, including an estimation of patency during systole and diastole. To our knowledge, this is only the second reported case of this particular coronary artery anomaly in the world literature

OBJECTIVE: To evaluate the prevalence and characteristics of myocardial bridging in patients who underwent single- or dual-source multidetector cardiac computed tomographic angiography (MDCTA). METHODS: Retrospective review of the imaging characteristics of 57 myocardial bridges in 53 patients who underwent cardiac MDCTA examinations was performed. RESULTS: The prevalence of myocardial bridges was 10.4%, most of which were located in the mid-left anterior descending coronary artery. The average myocardial bridge length was 23.4 mm, and the average tunneled artery depth was 2.6 mm. CONCLUSIONS: Myocardial bridges are commonly found in patients who undergo cardiac multidetector computed tomographic angiograms on both single- and dual-source computed tomographic scanners and are most frequently located in the mid-left anterior descending coronary artery. Increasing utilization of cardiac MDCTA for noninvasive evaluation of coronary artery disease permits recognition, characterization, and functional assessment of this entity in a single examination

Continued improvements in multidetector computed tomographic (CT) scanners have made cardiac CT an important clinical tool that is revolutionizing cardiac imaging. Multidetector CT with submillimeter collimation and gantry rotation times under 0.5 seconds allows the acquisition of studies with high temporal resolution and isotropic voxels. The volumetric data set that is generated can be analyzed with a depth previously not possible, requiring a solid understanding of the cardiac anatomy and its appearance on CT scans and postprocessed images

OBJECTIVE: We describe the findings of contrast-enhanced gated cardiac CT in 15 patients with 23 incidentally noted cardiac ventricular diverticula. CONCLUSION: Cardiac diverticula most commonly occur in the left ventricle but have been reported to occur in all chambers of the heart. Despite reports of their rare occurrence, cardiac ventricular diverticula are fairly common findings in patients undergoing cardiac MDCT angiography.

Cardiac computed tomography (CT) is an evolving modality that includes a variety of examinations to assess the anatomy and pathology of the cardiac chambers, valves, myocardium, coronary arteries and veins, pericardium, aortic root, and central great vessels. The development of multidetector CT scanners with increasing numbers of detector rows, narrow section thicknesses, increasing scanner speeds, the ability for electrocardiographic gating, and radiation dose modulation allows the performance of CT coronary arteriography. Computed tomography coronary arteriography enables the assessment of multiple types of cardiac pathology, including intraluminal coronary arterial plaque formation, coronary artery stenosis, congenital anomalies, coronary artery aneurysms, sequelae of cardiac ischemia, and the assessment of prior vascular interventions, while providing information about cardiac and valvular function. Noncardiac structures included in cardiac CT examinations must also be evaluated. This guideline attempts to maximize the probability of detecting cardiac abnormalities with cardiac CT. American College of Radiology requirements for physicians and personnel performing examinations are also addressed and will become applicable by July 1, 2008

OBJECTIVE. The objective of our study was to evaluate the image quality of 64-MDCT coronary angiography. SUBJECTS AND METHODS. Fifty consecutive CT coronary angiograms obtained on a scanner were independently reviewed by two reviewers. Segments were scored as no motion (score of 1), minimal motion (2), moderate motion (3), respiratory motion (4), vessel blurting (5). Opacification was graded as good (score of 1) or limited (2). Segments < 2 were graded as well seen; or as poorly seen or not seen. The scores for motion artifact, opacification, and visibility were combined for overall vessel assessment. Segments with a motion of 1 or 2 that had good opacification and were well seen were judged to be assessable. RESULTS. A total of 714 segments were analyzed in 50 patients. Seven hundred segments assessed in all patients (segments 1-3, 11-20, 4, or 27), and a ramus intermedius segment evaluated in 14 patients. Combining the scores for both reviewers, the average motion score I for 619 segments (86.7%), the average motion score for all segments in an individual patient 1.14 (range, 1-3.35), and the average opacification score for all segments in a patient was (range, 1-1.38). A total of 374 segments were less than 2 min in diameter. Combining the for both reviewers, an average of 36 segments (5.0% of 714) could not be identified by the 319.5 segments (85.4%) were well seen, and 18.5 segments (4.9%) were poorly seen. an average of 637 segments (89.2%) were judged assessable by the reviewers. On a per-patient basis, 10 or more vessel segments werejudged assessable in 47 patients (94%). CONCLUSION. On 64-MDCT, 89% of coronary artery segments are assessable. Ten or vessel segments are assessable in 94% of patients

Cardiac multidetector helical computed tomography angiogram (MDCTA) findings of a quadricuspid aortic valve are presented. MDCTA enabled evaluation of the aortic valve and its function, the coronary arteries, and left ventricular function. This case is, to our knowledge, the first description of the MDCTA imaging appearance of quadricuspid aortic valve