Multislice computed tomography angiography in the diagnosis of cardiovascular disease: 3D visualizations

Multislice computed tomography (CT) has been widely used in clinical practice for the diagnosis of cardiovascular disease due to its reduced invasiveness and high spatial and temporal resolution. As a reliable alternative to conventional angiography, multislice CT angiography has been recognized as the method of choice for detecting and diagnosing head and neck vascular disease, abdominal aortic aneurysm, aortic dissection, and pulmonary embolism. In patients with suspected coronary artery disease, although invasive coronary angiography still remains as the gold standard technique, multislice CT angiography demonstrates high diagnostic accuracy; in selected patients, it is considered as the first-line technique. The imaging diagnosis of cardiovascular disease is based on a combination of two-dimensional (2D) and three-dimensional (3D) visualization tools to enhance the diagnostic value. This is facilitated by reconstructed visualizations which provide additional information about the extent of the disease, an accurate assessment of the spatial relationship between normal structures and pathological changes, and pre-operative planning and post-procedure follow-up. The aim of the present article is to present an overview of the diagnostic performance of various 2D and 3D CT visualizations in cardiovascular disease, including multiplanar reformation, maximum intensity projection, volume rendering, and virtual intravascular endoscopy. The recognition of the potential value of these visualizations will assist clinicians in efficiently using the multislice CT imaging modality for the diagnostic management of patients with cardiovascular disease.