Current Problems in Cardiology
Volume 34, Issue 4 , Pages 145-217, April 2009

Coronary Computed Tomography and Magnetic Resonance Imaging

Abstract 

Cardiac computed tomography and magnetic resonance are relatively new imaging modalities that can exceed the ability of established imaging modalities to detect present pathology or predict patient outcomes. Coronary calcium scoring may be useful in asymptomatic patients at intermediate risk. Computed tomographic coronary angiography is a first-line indication to evaluate congenitally abnormal coronary arteries and, along with stress magnetic resonance myocardial perfusion imaging, is useful in symptomatic patients with nondiagnostic conventional stress tests. Cardiac magnetic resonance is indicated for visualizing cardiac structure and function, and delayed enhancement magnetic resonance is a first-line indication for assessing myocardial viability. Imaging plaque and molecular mechanisms related to plaque rupture holds great promise for the presymptomatic detection of patients at risk for coronary events but is not yet suitable for routine clinical use.

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 The use of gadolinium chelates for cardiovascular magnetic resonance imaging as discussed in this article is off-label and not FDA-approved.

 Eike Nagel is a consultant to Berlex/Schering and Bracco.

 Jörg Barkhausen receives honorariums from Schering and Siemens, receives research grants from Schering and Guerbet, is a consultant for Schering and Guerbet, and is on the advisory board of Guerbet.

 Paul Schoenhagen receives an honorarium from Takeda Pharmaceuticals (paid directly to charity and higher education).

 Thomas C. Gerber is an associate editor of Mayo Clinic Proceedings.

 The authors have no other conflicts of interest to disclose.

 This work was supported in part by NIH Grant 1R01EB007986-02 (“Noninvasive Localization of Vulnerable Plaques”) awarded to Dr. Birgit Kantor.

PII: S0146-2806(08)00184-9

doi:10.1016/j.cpcardiol.2008.12.002

Current Problems in Cardiology
Volume 34, Issue 4 , Pages 145-217, April 2009