Cardiac CT by Marc Dewey

Author:Marc Dewey
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

In addition to motion artifacts resulting from a rapid or irregular heartbeat, heavily calcified coronary segments pose the greatest challenge because they obscure the coronary artery lumen (Fig. 11.12 ). Heavily calcified segments may not be evaluable, although severe calcifications do not per se exclude evaluation. In this situation, visualization of coronary stenoses can be improved by using specific window-level settings (Fig. 11.13 ).

Fig. 11.14Three-dimensional reconstructions (Panel A) and maximum-intensity projections (Panel B) do not allow the assessment of severely calcified coronary artery plaques, as shown here in the left anterior descending (LAD), intermediate branch (IMB), and obtuse marginal branch (OM). Because of the projectional nature of maximum-intensity projections, calcified plaques can even be overemphasized (i.e., blooming; Panel B). Such blooming artifacts are less pronounced on curved multiplanar reformations and standard two-dimensional images with bone-window-type settings (Fig. 11.13 ). In this patient, conventional coronary angiography revealed significant stenoses in all three vessels

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