Plaque and Stenosis Imaging

Over the past decade, cardiac Computed Tomography (CT) has developed into a valuable cardiac imaging tool. CT imaging of the coronary arteries allows for non-invasive assessment of coronary atherosclerosis and narrowing of the coronary lumen. Quantitative tools are available to measure the lumen dimensions as well as the volume of atherosclerotic plaque. Cardiac CT can further be employed to assess coronary bypass grafts and certain types of coronary stents/scaffords.

Non-coronary Applications and Valve Analysis

Non-coronary applications of cardiac CT include quantification of contractile ventricular function and more recently developed techniques such as myocardial perfusion and late myocardial enhancement imaging. Cardiac CT has excellent three-dimensional spatial resolution and offers unmatched structural assessment of the heart, i.e. the left atrium and its appendage, the pulmonary and cardiac veins or valves.

Prior to percutaneous valve interventions, cardiac CT can display the anatomy and dimensions of the left ventricular outflow tract, which is important for procedure preparation and selection of the type and size of devices. In addition, peripheral vascular access routes can be assessed by CT.

CT Syntax Score

The Syntax Score is an angiographic tool to grade the complexity of coronary artery disease by characterizing the entire coronary tree with respect to the number of lesions and their functional impact, location and complexity. The Syntax Score can also be used to compare the complexity of coronary artery disease in individual patients and entire patient cohorts. At the Cardialysis Core Lab, we also apply the newly developed multislice computed tomography (CT) Syntax Score.

Previous and ongoing projects involve quantitative CT angiographic follow-up after percutaneous coronary interventions, monitoring of bypass graft patency and pre-TAVI evaluations. Our services include trial design and CT endpoints, acquisition guidelines, web-based training and certification of CT acquisition sites, CT data handling, independent qualitative and quantitative CT readings.

Literature references