Cardiology overview imaging
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Cardiology Overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Angiography
- Assess coronary lumen, not wall of artery
- Inaccurate and variable in the assessment of short, diffusely diseased left main lesions
- Provides less functional information than fractional flow reserve
- Should be combined with fractional flow reserve in intermediate lesions. PCI should be performed if FFR is < 0.80. It is safe to hold off on PCI in intermediate lesions with an FFR > 0.80 as shown in the FAME study.
CT Scanning
- CT scanning is not recommended as a screening tool in the asymptomatic patient
- A negative CT scan in a patient with a low pre test probability of disease has a high negative predictive value (>90%) in excluding the presence of CAD
- CT of stented patients can be difficult to interpret due ot bloassoming artifact
- CT is useful in the assessment of sapehanous vein graft patency
Echocardiography
- The E/E* ratio is a new criteria to assess diastolic dysfunction.
- Echocardiography tends to overestimate that gradient in aortic stenosis
MRI
- Useful in the differentiation of myocarditis (subepicardial pattern) from myocardial infarction (subendocardial pattern)
- Useful in the assessment of pericardial thickening in the assessment of contstrictive pericarditis
- Useful in the assessment of myocardium in the assessment of fibrosis in hypertrophic obstructive cardiomyopathy (HOCM)
- Useful in the assessment of hemochromatosis and to follow magnitude of iron overload