ABSTRACT
Contrast-enhanced CT provides detailed anatomic information about the cardiac chambers and the myocardium. It is primarily a static anatomic modality, which is utilized if morphologic findings are in question. The high spatial resolution and ability to reconstruct the acquired 3-D data set along oblique axes allow assessment of global and focal myocardial pathology. CT can therefore provide useful information in patients with non-ischemic and ischemic cardiomyopathies. However, in the assessment of these conditions the evaluation of ventricular function and integrity of the valvular structures is essential, and echocardiography 29 and MRI 70 are typically the initial tests of choice. CT data acquisition throughout the cardiac cycle (retrospective gating) and subsequent reconstructions along different phases of the cardiac cycle allow limited functional assessment (Figures 2.6 and 2.7). However, because of lower temporal resolution, associated contrast, and radiation exposure, its role is typically restricted to clinical scenarios in which echocardiography and MRI are not possible or significantly limited. In the assessment of left ventricular (LV) measurements with MDCT, studies show a good correlation of left ventricular ejection fraction (LVEF) values with cine-MRI, but significant underestimation of LV volumes with MDCT. 30–33
