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Updated: Jul 31, 2025
Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
Cardiac computed tomography: from anatomy to function
Riccardo Maragna1, Saima Mushtaq1, Andrea Baggiano1,2
1Department of Periooperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, via Parea 4, 20138 Milan, Italy.
Insights
Coronary computed tomography angiography offers a non-invasive way to assess coronary artery disease (CAD) and ischaemic heart disease (IHD). This review explores its advanced applications for evaluating atherosclerotic burden and functional relevance.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Ischaemic heart disease (IHD) is a major global health concern.
- Current diagnostic methods for coronary artery disease (CAD) excel at detecting obstructive blockages but struggle with non-obstructive disease.
- Coronary computed tomography angiography (CCTA) provides non-invasive anatomical assessment.
Purpose of the Study:
- To review the technical aspects and clinical utility of coronary computed tomography (CT) in evaluating atherosclerotic burden.
- To highlight emerging applications of coronary CT, including functional assessment and inflammatory marker imaging.
- To discuss the strengths and limitations of various coronary CT approaches.
Main Methods:
- Review of current literature on coronary computed tomography angiography (CCTA).
- Evaluation of technical aspects and clinical experience with CCTA.
- Focus on advanced CCTA applications: CT-derived fractional flow reserve (FFRct), stress CT perfusion, and inflammatory marker imaging.
Main Results:
- CCTA is valuable for assessing coronary anatomy and atherosclerotic burden non-invasively.
- Emerging techniques like FFRct and stress CT perfusion offer insights into the functional significance of CAD.
- Imaging inflammatory markers with CT is an evolving area for risk stratification.
Conclusions:
- Coronary CT angiography is a crucial tool for diagnosing and managing patients with suspected or chronic IHD.
- Advanced CT applications are expanding its role in assessing both the extent and functional impact of CAD.
- Further research is needed to fully establish the clinical value of novel CT imaging techniques for CAD.
Abstract:
Ischaemic heart disease (IHD) is one of the world's leading causes of morbidity and mortality. Likewise, the diagnosis and risk stratification of patients with coronary artery disease (CAD) have always been based on the detection of the presence and extent of ischaemia by physical or pharmacological stress tests with or without the aid of imaging methods (e.g. exercise stress, test, stress echocardiography, single-photon emission computed tomography, or stress cardiac magnetic resonance). These methods show high performance to assess obstructive CAD, whilst they do not show accurate power to detect non-obstructive CAD. The introduction into clinical practice of coronary computed tomography angiography, the only non-invasive method capable of analyzing the coronary anatomy, allowed to add a crucial piece in the puzzle of the assessment of patients with suspected or chronic IHD. The current review evaluates the technical aspects and clinical experience of coronary computed tomography in the evaluation of atherosclerotic burden with a special focus about the new emerging application such as functional relevance of CAD with fractional flow reserve computed tomography (CT)-derived (FFRct), stress CT perfusion, and imaging inflammatory makers discussing the strength and weakness of each approach.
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