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Techniques for imaging the heart and great vessels

A.  Radiography
B. Computed tomography
 
 
 
 
  1. Indications
 
 
 
 

  a) Coronary calcium scoring
   
   
   
    b) Cardiac CT
   
   
    c) Coronary CTA
   
  • CT of Coronary Artery Disease 
    Gorka Bastarrika, Yeong Shyan Lee, Walter Huda, Balazs Ruzsics, Philip Costello, and U. Joseph Schoepf 

    Radiology November 2009 253:2 317-338; doi:10.1148/radiol.2532081738
   
 
2. Physics and cardiac imaging considerations including ECG gating techniques
 


Pitfalls to Avoid in Cardiac CT
Shawn D. Teague, MD

(Cartoons: Peter Griffen, Family Guy, Fox Broadcasting Company; Realistic Stress Test from http://www.medical-jokes.com; ScienceCartoonplus.com – Sidney Harris Cartoons)

 
 
 
    a) Coronary artery calcium scoring
   
   
    b) Coronary CTA
   
   
    c) Aortic CTA
   
   
  • CT Angiography: Current Technology and Clinical Use
    Kanako K. Kumamaru, MD, Bernice E. Hoppel, PhD,Richard T. Mather, PhD, and Frank J. Rybicki, MD, PhD
    Radiol Clin North Am. 2010 March; 48(2): 213–235. doi: 10.1016/j.rcl.2010.02.006PMCID: PMC2901244 NIHMSID: NIHMS180757
   
    d) Pulmonary CTA
   
   
  3. Advantages and limitations
 
 
 
  4. Protocols for specific clinical question (e.g. patients with grafts, combined aortic and coronary artery disease, triple rule out)
 
 
 
  5. Radiation reduction tools
 
 
 
  6. Patient selection and preparation, contraindications
 
 
C. Magnetic resonance imaging
  • Patient preparation and scanning techniques. 
    Taylor CM, Blum A, Abbara S. 
    Radiol Clin North Am. 2010 Jul ;48(4):675-86.
  • Cardiac MRI: The Basics 
    Patrick T. Norton, M.D., Nicholas C. Nacey, M.D., Dominique B. Caovan, M.D., Spencer B. Gay, M.D., Christopher M. Kramer, M.D., Bryan S. Jeun, M.D.
    University of Virginia Health System, Department of Radiology
  1. Indications
 
 
 
  2. Physics and imaging considerations, including pulse sequences, ECG-gating techniques, and respiratory compensation strategies
 
 
 
    a) Wall motion studies and tagging
   
   
    b) Myocardial perfusion and viability scanning
   
   
  • MRI for the Assessment of Myocardial Viability (Abstract)
    Jonathan W. Weinsaft, Igor Klem, Robert M. Judd 
    Magnetic Resonance Imaging Clinics of North America – November 2007 (Vol. 15, Issue 4, Pages 505-525, DOI: 10.1016/j.mric.2007.08.007) 
   
    c) Valvular disease assessment
   
   
   
    d) Blood flow quantification
   
   
    e) Coronary MRA
   
  • Coronary magnetic resonance angiography (Abstract)
    Matthias Stuber PhD, Robert G. Weiss 
    Journal of Magnetic Resonance Imaging Volume 26, Issue 2, pages 219–234, August 2007 DOI: 10.1002/jmri.20949 
   
   
    f) MR of the aorta
   
  • Technical Principles of MR Angiography Methods (Abstract)
    Marko K. Ivancevic, Liesbeth Geerts, William J. Weadock, Thomas L. Chenevert 
    Magnetic Resonance Imaging Clinics of North America – February 2009 (Vol. 17, Issue 1, Pages 1-11, DOI: 10.1016/j.mric.2009.01.012) 
   
   
  • Low dose CE-MRA (Abstract)
    Kambiz Nael, John M. Moriarty, J. Paul Finn 
    European Journal of Radiology – October 2011 (Vol. 80, Issue 1, Pages 2-8, DOI: 10.1016/j.ejrad.2011.01.092) 
    g) Pulmonary MRA
   
   
    h) Atherosclerotic plaque evaluation
   
   
   
    i) Stress Testing
  3. Advantages, limitations, and contraindications
 
 
 
D. Cardiac scintigraphy (including PET)
 
1. Indications
 
  • Cardiac Positron Emission Tomography
    Frank M. Bengel, MD, , Takahiro Higuchi, MD, Mehrbod S. Javadi, MD, Riikka Lautamäki, MD, PhD
    Journal of the American College of Cardiology Volume 54, Issue 1, 30 June 2009, Pages 1–15 doi: 10.1016/j.jacc.2009.02.065
 
  • Nuclear Cardiology
    David K. Shelton, Jr., MD
    Society of Thoracic Radiology 2010 Meeting Lectures
 
  2. Physics and cardiac imaging considerations
    a) Multiple-gated acquisition (MUGA)
   
  • Cardiac CT, PET and MR
    Editor(s): Vasken Dilsizian, Gerald M. Pohost
    Print ISBN: 9781405124478, Online ISBN: 9780470988534, DOI: 10.1002/9780470988534
    Copyright © 2006 by Blackwell Publishing
   
   
    b) Myocardial perfusion and viability scanning
   
   
   
    c) Shunt evaluation
   
  • Cardiac CT, PET and MR
    Editor(s): Vasken Dilsizian, Gerald M. Pohost
    Print ISBN: 9781405124478, Online ISBN: 9780470988534, DOI: 10.1002/9780470988534
    Copyright © 2006 by Blackwell Publishing
   
   
    d) Rb-82 PET CT
   
  • Cardiac CT, PET and MR
    Editor(s): Vasken Dilsizian, Gerald M. Pohost
    Print ISBN: 9781405124478, Online ISBN: 9780470988534, DOI: 10.1002/9780470988534
    Copyright © 2006 by Blackwell Publishing
   
   
 
3. Advantages and limitations
 
 
 
E. Other (working understanding)
 
1. Echocardiography (transthoracic and transesophageal)
    a) Indications
    b) Technique including standard views and use of color Doppler
    c) Advantages and limitation
 
2. Cardiac and coronary catheter angiography
    a) Indications
   
   
  • Low Diagnostic Yield of Elective Coronary Angiography
    Manesh R. Patel, M.D., Eric D. Peterson, M.D., M.P.H., David Dai, M.S., J. Matthew Brennan, M.D., Rita F. Redberg, M.D., H. Vernon Anderson, M.D., Ralph G. Brindis, M.D., and Pamela S. Douglas, M.D.
    N Engl J Med 2010; 362:886-895March 11, 2010DOI: 10.1056/NEJMoa0907272
   
    b) Technique including standard views and transcatheter tools (e.g. intraluminal ultrasound)
   
   
   
   
    c) Advantages and limitations