By Schoenhagen, MD, FAHA, Paul

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Extra info for Cardiac CT Made Easy: An Introduction to Cardiovascular Multidetector Computed Tomography, Second Edition

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Recently, the quantification of calcium from contrast-enhanced MDCT images has been proposed, using a threshold equal to 350 Hounsfield units (HU)81. Coronary calcium scores have been shown to correlate with the total atherosclerotic plaque burden (calcified and non-calcified plaque)82,83, and the predictive value of the overall EBCT calcium score for future coronary events has been shown84,85. Dynamic changes in the calcium volume score during pharmacological therapy have been examined in serial CT studies86,87.

Findings consistent with tamponade are right ventricular collapse or indirect signs including enlargement of the hepatic veins (Figure 80). However, a functional assessment of tamponade physiology is the strength of echocardiography and MRI19. Figure 79 Postoperative pericardial effusion A patient after replacement of the ascending aorta. A supracoronary graft of the ascending aorta is seen (arrow, left panel). Small- to moderate-sized circumferential pericardial effusion without evidence of tamponade.

The left main coronary artery (LM) and proximal portions of the left anterior descending artery (LAD), are more reliably visualized than segments with more pronounced motion, including parts of the right coronary artery (RCA) and circumflex coronary artery (LCX), and smaller segments. Coronary arterial motion varies during the cardiac cycle, and individual arteries reach peak velocity at different times during the cardiac cycle119. Therefore, to assess optimally all coronary arteries in one patient, image reconstruction is often performed at several phases in the cardiac cycle120,121.

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