ABSTRACT
The early assessment of coronary artery disease (CAD) includes evaluation of coronary arteries, myocardial perfusion-fibrosis, and cardiac chambers' function, using the currently available imaging techniques. In this chapter we will present the engineering and the clinical aspects of echocardiography, cardiac computed tomography, and cardiovascular magnetic resonance imaging and their role in the early diagnosis of CAD. To initially present the engineering aspects of all these imaging modalities, the following paragraphs 1.1–1.3 detail modern image acquisition and analysis techniques for magnetic resonance imaging, computed tomography, and ultrasounds that have been developed and/or are under further development work, to improve the diagnosis and response to therapy assessments of coronary artery disease (CAD). In that context, technical details, differences, as well as current limitations are discussed throughout.
Echocardiography is the cornerstone of cardiac imaging being widely available, non-radiating, inexpensive, and bedside. It can provide information both at rest and during stress. However, it is operator and window dependent. CT coronary angiography offers excellent negative predictive value in the evaluation of coronary arteries but at the cost of radiation. Recently cardiovascular magnetic resonance has become the modality of choice for function, perfusion (stress-) rest and fibrosis (either replacement or diffuse) assessment, because it has excellent reproducibility, is non-radiating, and also is operator and window independent.
