By Schoenhagen, MD, FAHA, Paul
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Extra resources for Cardiac CT Made Easy: An Introduction to Cardiovascular Multidetector Computed Tomography, Second Edition
5) can be defined in relation to adjacent structures. 5 Cardiac masses Cardiac masses can be described with regard to size, density, contrast enhancement, and spatial relationship to adjacent structures146. However, the morphology of tumors is highly variable, and qualitative assessment with CT is limited. Because of its superior tissue characterization, MRI often allows further qualitative classification and should be considered complementary146,147. A frequent clinical question is the differentiation between benign and malignant processes.
During subsequent open-heart surgery, repair of the ascending aortic dissection with resuspension of the aortic valve, replacement of the ascending aorta with Hemashield graft, and bypass surgery with venous aorto-coronary graft to the LAD, LCX, and RCA were performed. qxp 46 11/8/2006 8:49 PM Page 46 CARDIAC CT MADE EASY Case 15: Figures 65 and 66: coronary stent Figure 65 shows angiographic and intravascular ultrasound images of a patient with moderate instent restenosis and severe stenosis at the stent edges.
Typical results describe a density of < 50 HU for soft plaques, 50–120 HU for intermediate plaques, and > 120 HU for calcified lesions. Semi-automated software systems for plaque analysis are currently being evaluated. The rationale of these studies is that the identification of ‘vulnerable’ atherosclerotic lesions and the overall plaque burden could provide better markers of coronary risk than measures of luminal stenosis105–109. 2 Stenotic, clinical CAD Coronary CT angiography (CTA) Challenges for coronary CT angiography (CTA) are the small size of coronary arteries, the tortuous course, and the fast motion during the cardiac cycle110–118.