Imaging Coronary Arteries

Cardiovascular and Coronary Artery Imaging, Volume One covers state-of-the-art approaches for automated non-invasive systems in early cardiovascular disease diagnosis. The book includes several prominent imaging modalities, such as MRI, CT and PET technologies. A special emphasis is placed on automated imaging analysis techniques, which are important to biomedical imaging analysis of the cardiovascular system. This is a comprehensive, multi-contributed reference work that details the latest developments in spatial, temporal and functional cardiac imaging. Takes an integrated approach to cardiovascular and coronary imaging, covering machine learning, deep learning and reinforcement learning approaches Covers state-of-the-art approaches for automated non-invasive systems for early cardiovascular disease diagnosis Provides a perspective on future cardiovascular imaging and highlights areas that still need improvement

In non-fatal cases, cardiovascular diseases are associated with a decreased quality of life as well as a substantial economic burden to society. Most sudden cardiac events are related to the complications of a non-stenosing marginal plaque. For this reason, the ability to properly identify the atherosclerotic plaque with rapid, non-invasive techniques is of utmost clinical interest in diagnostic workup and therapeutic planning of symptomatic patient. Nowadays CT produces high-quality images of the coronary arteries, in addition to defining their location and the extent of the atherosclerotic involvement. This new edition is enriched with two important additions. Firstly, dedicated chapters on intravascular ultrasound (IVUS), catheter angiography, and nuclear imaging have been included, with some discussions on theoretical techniques such as optical coherence tomography (OCT) and magnetic resonance imaging (MRI). Secondly, a completely new section comprising more than 70 clinical cases remarkably expands the horizons reached by the previous edition. This volume provides general practitioners and cardiologists with a basic understanding of the imaging techniques. For radiologists with no direct experience in cardiac imaging, the book serves as an important source of information on coronary pathophysiology and anatomy.

Co-authored by a nuclear cardiologist and a cardiologist, this book presents practical, up-to-date information on diagnostic imaging for coronary artery disease, including coronary CT angiography, cardiac SPECT, cardiac PET, and MRI. The authors present the basic concepts and must-know facts of these modalities and offer guidelines for risk stratification of coronary artery disease. Test questions for board review are included. A companion Website will contain clinical case examples of coronary CT angiography studies and nuclear studies. Full-color images of black-and-white print CT, SPECT, and PET materials will be included. The Website will also include 31 video clips.

In the intervening 10 years tremendous advances in the field of cardiac computed tomography have occurred. We now can legitimately claim that computed tomography angiography (CTA) of the coronary arteries is available. In the evaluation of patients with suspected coronary artery disease (CAD), many guidelines today consider CTA an alternative to stress testing. The use of CTA in primary prevention patients is more controversial in considering diagnostic test interpretation in populations with a low prevalence to disease. However the nuclear technique most frequently used by cardiologists is myocardial perfusion imaging (MPI). The combination of a nuclear camera with CTA allows for the attainment of coronary anatomic, cardiac function and MPI from one piece of equipment. PET/SPECT cameras can now assess perfusion, function, and metabolism. Assessing cardiac viability is now fairly routine with these enhancements to cardiac imaging. This issue is full of important information that every cardiologist needs to now.

For over 50 years, coronary angiography has been the mainstay of diagnosing and quantifying the extent of coronary artery disease. However appreciation of the inherent limitations of conventional angiography has led to a plethora of new imaging modalities, each with their relative strengths and potential pitfalls. Advances in these techniques have given clinicians, as well as researchers, an overwhelming amount of information and the need for thoughtful interpretation. This outstanding book provides a comprehensive overview of the current status of imaging of coronary atherosclerosis. Covering the wide variety of available imaging modalities, the book provides state-of-the-art knowledge from leading authorities in each area. In their discussion, the authors include both invasive and non-invasive modalities, including the gold standard coronary angiography, the growing field of IVUS, and novel techniques such as functional imaging, molecular imaging, and the integration of biomarkers. The key concepts and practical information given in this volume will provide the reader with the necessary understanding to choosing appropriate imaging studies and building confidence in their skill set with each.

Updated to reflect the notable advances in cardiac computed tomography (CT) imaging, the Second Edition of the best-selling Computed Tomography of the Coronary Arteries provides cardiologists and radiologists with a practical text that explains the basic principles and applications of CT. Written by renowned international experts in the field, this

Cardiovascular disease has become the number one cause of death worldwide. For the diagnosis and therapy of coronary artery disease, interventional C-arm-based fluoroscopy is an imaging method of choice. While these C-arm systems are also capable of rotating around the patient and thus allow a CT-like 3-D image reconstruction, their long rotation time of about five seconds leads to strong motion artefacts in 3-D coronary artery imaging. In this work, a novel method is introduced that is based on a 2-D-2-D image registration algorithm. It is embedded in an iterative algorithm for motion estimation and compensation and does not require any complex segmentation or user interaction. It is thus fully automatic, which is a very desirable feature for interventional applications. The method is evaluated on simulated and human clinical data. Overall, it could be shown that the method can be successfully applied to a large set of clinical data without user interaction or parameter changes, and with a high robustness against initial 3-D image quality, while delivering results that are at least up to the current state of the art, and better in many cases.

2 Diagnostic Use of Radiographic Methods in Coronary Disease. . . . . . . . . . . . . . . . . . . . . . . . . . 56 3 Material. . . . . . . . . . . . . . . . . . . . . . . . . 58 4 Mode of Operation . . . . . . . . . . . . . 62 5 Radiological Projections. . . . . . . . . . . . . . . . . 63 6 Monitoring of Cardiac Parameters . . . . . . . . . . . . 64 7 Pharmacological Tests . . . . . . . . . . . . . . . . 66 7. 1 Coronary Arteries . . . . . . . . . . . . . . . . . . . . . 66 7. 2 Left Ventricle. . . . . . . . . . . . . . . . . . . . . . . . 67 8 Accidents and Risks of Coronary Arteriography . . . . . 67 References . . . . . . . . . . . . . . . . . . . . . . . . . 68 III Angiographic Explorations: Normal Results . . . 71 1 Left Ventricle and Left Ventricular Function 71 1. 1 Radiological Anatomy. . . . . . . . . . . . 71 1. 2 Normal Kinetics. . . . . . . . . . . . . . . 77 1. 3 Analysis of Wall Contraction . . . . . . 78 1. 4 Volumes and Function Indexes. . . . . . . 81 2 Coronary Arteries and Veins . . . . . . . . 84 2. 1 Origin, Calibre and Preponderance of the Coronary Arteries . . . . . . . . . . . . . . . . . . . . . . . . 84 2. 2 Nomenclature and Segmentation of the Coronary Arteries . . . . . . . . . . . . . . . . . . . . . . 87 2. 3 A Reminder About the Physiology of Coronary Circulation . . . . . . . . . . . 93 2. 4 Angiographic Anatomy . . . . . . . . . . 94 2. 4. 1 Left Coronary Artery . . . . . . . . . . . 94 2. 4. 2 Right Coronary Artery. . . . . . . . . . . . . 95 2. 4. 3 Vascularization of Nodes and the Conduction System . . 96 2. 4. 4 Interconnecting Anastomoses . . . . . . . . . . . . . . . 97 2. 5 Coronary Veins . . . . . . . . . . . . . . . . . . . 97 References . . . . . . . . . . . . . . . . . . . . . . . . . 98 IV Angiographic Explorations: Congenital Anomalies of the Coronary Arteries. . . . . . . . . . . . . . . . . . . . . . . . 100 1 Anomalies of the Origin, Course and Distribution of Coronary Arteries Arising from the Aorta . . . . . . . . 100 2 Abnormal Origin of a Coronary Artery from the Pulmonary Artery . . . . . . . . . . . . . . . . . . . . . 101 3 Anomalies in the Diameter of Coronary Arteries . . . . . 104 4 Coronary Fistulae . . . . . . . . . . . 109 References . . . . . . . . . . . . . . . . . . . . . . . . . 113 VII V Angiographic Explorations: Coronary Atheroma. . . . . . . . 114 1 Left Ventricle . . . . . . . . . . . . . . . . . . . . . . . . 114 1. 1 Morphological Anomalies: Bulging and Lacuna-Like Aspects . . . . . . . . . . . . . . . . . . . . . . . . . . .