Detection of Incidental Noncoronary Cardiac and Extracardiac Lesions Coronary CT angiography (CTA) may encounter both significant and nonsignificant noncoronary cardiac lesions. An overview of these lesions is presented in Table 30-1 ; their treatment has been reviewed in the preceding chapters of this book. An overview of significant and nonsignificant extracardiac findings is presented in Table 30-2 ; their treatment is discussed in this chapter. The term…

The cavae are large vessels with near-vertical orientation, which makes them particularly accessible for assessment by all manner of contrast-enhanced CT examinations, such as axial source imaging, as well as sagittal and coronal projections. In addition to being diseased, both the superior (SVC) and inferior (IVC) venae cavae have congenital variants that are regularly encountered and that have clinical relevance. Familiarity with the congenital variants of…

Pulmonary Artery Anatomy Normally, there are 17 bronchopulmonary segments, any of which may develop an embolism. The main pulmonary artery bifurcates into the right and left main pulmonary arteries. The right main pulmonary artery then trifurcates into three lobar arteries, which divide into segmental arteries (and subsequently into subsegmental arteries, which are not precisely distinguished from the segmental arteries by tomographic imaging): □ Upper lobe S1:…

Noninvasive assessment of carotid artery disease is desirable, as more than half of the permanent morbidity and mortality of the Asymptomatic Carotid Artery Surgery (ACAS) Trial was attributable to catheter-based angiography (1.3% of the 2.3% with permanent morbidity and mortality). The utility of multidirectional CT (MDCT) for the assessment of cerebrovascular, renal artery, and peripheral arterial disease is less studied and published than is its use…

CT scanning has emerged as the de facto test of choice for the identification of diseases of the aorta. As a result of its widespread and 24-hour availability, its suitability to evaluate critically ill patients (as long as they can be moved), and the appropriateness of its spatial and temporal resolution to the needs of most aortic pathologies, CT scanning has become the principal test for…

The established tests for the assessment of congenital heart disease are transthoracic and transesophageal echocardiography, cardiac MRI, and cardiac catheterization. Cardiac CT (CCT) is an emerging alternative, because of its rapid acquisition times and post-processing robustness. The potential radiation risks are particularly relevant for children and younger adults, especially because its use has increased prominently in the assessment of congenital heart disease. Most intracardiac lesions can…

The established tests for the assessment of congenital heart disease are transthoracic (TTE) and transesophageal echocardiography (TEE), cardiac MRI, and cardiac catheterization. Cardiac CT (CCT) is an emerging alternative because of its rapid acquisition times and post-processing robustness, but the potential radiation risks are particularly relevant for children and younger adults. Nonetheless, its use has increased prominently in the assessment of congenital heart disease. Most intracardiac…

Although CCT is able to image most lesions within the heart, especially larger ones, its role is secondary to those of echocardiography and MRI in the evaluation of lesions within the heart. CCT’s greatest contribution is to evaluate the thorax in detail for complex cardiac masses (both those extending into the heart and those located elsewhere). Neither transthoracic nor transesophageal echocardiography has sufficient field of view…