Radiologic Clinics of North America RSS feed: Current Issue. Radiologic Clinics of North America brings you comprehensive, clinical information that can be applied directly to your practice. Each bimonthly issue covers one current topic in radiology under the guidance of a guest editor specializing in the field. You'll find detailed articles written by leading experts, along with high-quality reproductions of radiographs, MR images, CT scans and sonograms. In addition, you can earn valuable CME credits - up to 90 per year - with your subscription.http://www.radiologic.theclinics.com/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Radiologic Clinics of North America0033-8389484July 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.radiologic.theclinics.com/article/PIIS0033838910001272/abstract?rss=yesContributors List10.1016/S0033-8389(10)00127-2Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5iiivhttp://www.radiologic.theclinics.com/article/PIIS0033838910001284/abstract?rss=yesContents10.1016/S0033-8389(10)00128-4Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5viiixhttp://www.radiologic.theclinics.com/article/PIIS0033838910001156/abstract?rss=yesCME Accreditation Page and Author Disclosure10.1016/j.rcl.2010.07.001Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5xixihttp://www.radiologic.theclinics.com/article/PIIS0033838910001296/abstract?rss=yesForthcoming Issues10.1016/S0033-8389(10)00129-6Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5xiixiihttp://www.radiologic.theclinics.com/article/PIIS0033838910000953/abstract?rss=yes With recent advances in computed tomographic (CT) technology, noninvasive CT imaging of the heart has become a reality. In this issue of Radiologic Clinics of North America, a renowned group of cardiac CT imagers addresses the important components of performing and interpreting cardiac CT examinations. One's diagnostic capabilities are dependent on acquisition of a motion-free, optimally enhanced CT data set using suitable CT equipment and on accurate interpretation of the appropriately postprocessed images. Because of this, a thorough understanding of proper patient selection and preparation, optimization of CT scanning protocols, and knowledge of postprocessing techniques is mandatory when performing an optimized cardiac CT examination. These important topics are therefore initially addressed in this issue.PrefaceJill E. Jacobs10.1016/j.rcl.2010.06.013Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5xiiixiiihttp://www.radiologic.theclinics.com/article/PIIS0033838910000321/abstract?rss=yesCoronary computed tomography angiography (CCTA) has become an important tool in the assessment of coronary artery disease. It is considered an appropriate test for several indications, including the evaluation of symptomatic patients with low to intermediate probability of obstructive coronary disease. Since its first applications in 1999 using 4-slice CT there have been numerous technological advancements, enabling excellent submillimeter spatial resolution and significant improvements in temporal resolution. This article reviews these advancements in CT technology and the current status and recent developments in cardiac CT with regards to spatial, temporal and contrast resolution and z-axis (volume) coverage. The article also describes the many techniques and new technologies available for dose reduction in cardiac CT.Cardiac Computed Tomography Technology and Dose-reduction StrategiesJames P. Earls, Jonathon Leipsic10.1016/j.rcl.2010.04.003Radiologic Clinics of North America 48, 4 (2010)2010-06-11Radiologic Clinics of North America2010-06-11484S0033-8389(10)X0004-5657674http://www.radiologic.theclinics.com/article/PIIS0033838910000400/abstract?rss=yesCardiac computed tomographic angiography (CCTA) is a unique diagnostic modality that can provide a comprehensive assessment of cardiac anatomy. Rapid advances in scanner and software technology have resulted in the ability to noninvasively image the coronary arteries. However, careful patient preparation and scanning technique is required to ensure optimal image quality while minimizing radiation dose delivered. Important components of patient preparation include knowledge of the indications and contraindications for CCTA, patient screening, patient premedication, patient positioning, prescan instruction, and electrocardiograph lead placement. Scanning technique should be determined on a patient by patient basis and tailored according to age and radiation risk, body mass index and chest circumference, heart rate and variability, presence of stents, and coronary calcification.Patient Preparation and Scanning TechniquesCarolyn M. Taylor, Andrew Blum, Suhny Abbara10.1016/j.rcl.2010.04.011Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5675686http://www.radiologic.theclinics.com/article/PIIS0033838910000333/abstract?rss=yesCareful protocol design is essential to successfully perform coronary computed tomographic (CT) angiography, from patient preparation, to gating, to contrast infusion, to data acquisition, to data reconstruction parameters. The emergence of newer generation scanners with even larger numbers of detector arrays and dual tubes has further improved dataset quality. However, it is only with tailored interpretation of these datasets that the true value of the newest scanners will be implemented. Unless the user becomes skilled at analyzing CT data, the full potential of new technology will be minimized. This article presents experience based guidance on postprocessing techniques, from axial review to two-dimensional renderings to three dimensional reconstructions, to optimize analysis of cardiac CT data.Postprocessing Techniques for Cardiac Computed Tomographic AngiographyPamela T. Johnson, Elliot K. Fishman10.1016/j.rcl.2010.04.004Radiologic Clinics of North America 48, 4 (2010)2010-06-10Radiologic Clinics of North America2010-06-10484S0033-8389(10)X0004-5687700http://www.radiologic.theclinics.com/article/PIIS0033838910000709/abstract?rss=yesAccurate interpretation of cardiac computed tomography requires fundamental knowledge of the normal cardiac anatomy and its common variations. This article reviews the normal anatomy of the coronary arteries, cardiac chambers, and cardiac valves.Computed Tomographic Evaluation of the Normal Cardiac AnatomyJill E. Jacobs10.1016/j.rcl.2010.05.001Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5701710http://www.radiologic.theclinics.com/article/PIIS0033838910000357/abstract?rss=yesCoronary artery anomalies (CAA) are uncommon congenital variations in coronary anatomy, occurring in 0.2% to 1.2% of the general population, the majority of which are detected incidentally and have little clinical significance. A minority of CAA, primarily due to an interarterial course, is clinically significant, and may present with symptoms of myocardial ischemia, malignant ventricular arrhythmias, and even sudden cardiac death. Until recently, CAA were primarily detected at catheter coronary angiography. With recent advances in multidetector computed tomography (CT) technology and the use of electrocardiographic gating, coronary CT angiography provides an exquisite omnidimensional display of the anomalous coronary arteries and their relation to the adjacent structures noninvasively, and is the diagnostic test of choice. Understanding CAA morphology and clinical significance of CAA is important for establishing a diagnosis, and is essential for appropriate patient management and treatment planning.Imaging of Coronary Artery AnomaliesBaskaran Sundaram, Renee Kreml, Smita Patel10.1016/j.rcl.2010.04.006Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5711727http://www.radiologic.theclinics.com/article/PIIS0033838910000710/abstract?rss=yesCardiac CT scan has emerged from a research tool to a widely used clinical modality in the diagnostic management of coronary artery disease. Based on evidence of numerous clinical studies coronary CT angiography (cCTA) has emerged as a fast, accurate, and noninvasive alternative to conventional angiography in selected patient populations. A major strength of cCTA is its ability to combine information on the coronary artery anatomy, the vessel lumen, and atherosclerotic lesions. Recent investigations on the application of cCTA in myocardial perfusion imaging suggest that cCTA may allow analysis of the hemodynamic relevance of detected stenosis. Data is accumulating that supports its relevance for patient management and outcome. This article examines the role of cCTA for the evaluation of plaques and stenosis.Evaluation of Plaques and StenosisElisabeth Arnoldi, Thomas Henzler, Gorka Bastarrika, Christian Thilo, Konstantin Nikolaou, U. Joseph Schoepf10.1016/j.rcl.2010.05.002Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5729744http://www.radiologic.theclinics.com/article/PIIS0033838910000722/abstract?rss=yesThe past decade has brought rapid advances in CT technology, which allows increasingly precise application to the study of coronary arteries and acute chest pain. The literature has expanded to lend quantifiable justification to the intuitive appeal of a rapid, reproducible, 3D study of the heart and vasculature. More complete analysis of efficacy and costs on broader populations will further refine our understanding of how best to implement what may become the new gold standard. Meanwhile, evolving technology promises to further challenge radiologists and clinicians to optimize approach and diagnosis to acute chest pain.Evaluation of the Patient with Acute Chest PainAri Goldberg, Harold I. Litt10.1016/j.rcl.2010.05.003Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5745755http://www.radiologic.theclinics.com/article/PIIS0033838910000382/abstract?rss=yesAlthough conventional coronary angiography is used to evaluate the patency of coronary artery bypass grafts, it is invasive and has associated risks. The evolution of the multidetector CT (MDCT) has enabled accurate, noninvasive visualization of graft patency. This article identifies and describes typical MDCT findings in bypass grafts and native coronary arteries.Evaluation of Bypass Grafts and StentsMinh Lu, Joseph Jen-Sho Chen, Omer Awan, Charles S. White10.1016/j.rcl.2010.04.009Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5757770http://www.radiologic.theclinics.com/article/PIIS0033838910000370/abstract?rss=yesCardiac computed tomography angiography (CCTA) has emerged as a powerful noninvasive technique for anatomic evaluation of the coronary arteries. Multiple studies have demonstrated very good diagnostic accuracy for detection of coronary artery disease, particularly with 64-slice systems. CCTA allows for accurate assessment of myocardial structure, perfusion, and function comparable to established techniques. CCTA has the potential to be a ‘‘one-stop shop'’ because it can be used to assess coronary artery anatomy and myocardial structure, perfusion, and function. In this article, established and emerging CCTA techniques for the evaluation of myocardial structure, perfusion, and function are reviewed.Evaluation of Myocardial Abnormalities and IschemiaHersh Chandarana, Monvadi B. Srichai10.1016/j.rcl.2010.04.008Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5771782http://www.radiologic.theclinics.com/article/PIIS0033838910000369/abstract?rss=yesElectrocardiograph (ECG)-gated cardiac computed tomography (CT) angiography has great potential for the evaluation of the cardiac valves, with excellent image quality. The evidence-based, established clinical role of ECG-gated CT coronary angiography provides additional valuable information about valve morphology and function. A wide range of valve pathology, including congenital and acquired conditions, infectious endocarditis, and complications of valve replacement, can be assessed by cardiac CT imaging. Despite recent advances in CT technology, echocardiography remains the gold standard for noninvasive cardiac valve evaluation. Nevertheless, important clinical information about the valves can be obtained with coronary CT angiography examinations. Thus cardiac valve morphology and function should be routinely assessed and reported on coronary CT angiography examinations.Computed Tomography Evaluation of Cardiac Valves: A ReviewDominik Ketelsen, Elliot K. Fishman, Claus D. Claussen, Jens Vogel-Claussen10.1016/j.rcl.2010.04.007Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5783797http://www.radiologic.theclinics.com/article/PIIS003383891000031X/abstract?rss=yesImportant features of cardiac masses can be clearly delineated on cardiac computed tomography (CT) imaging. This modality is useful in identifying the presence of a mass, its relationship with cardiac and extracardiac structures, and the features that distinguish one type of mass from another. A multimodality approach to the evaluation of cardiac tumors is advocated, with the use of echocardiography, CT imaging and magnetic resonance imaging as appropriately indicated. In this article, various cardiac masses are described, including pseudotumors and true cardiac neoplasms, and the CT imaging findings that may be useful in distinguishing these rare entities are presented.Computed Tomography of Cardiac Pseudotumors and NeoplasmsNandan S. Anavekar, Crystal R. Bonnichsen, Thomas A. Foley, Michael F. Morris, Matthew W. Martinez, Eric E. Williamson, James F. Glockner, Dylan V. Miller, Jerome F. Breen, Philip A. Araoz10.1016/j.rcl.2010.04.002Radiologic Clinics of North America 48, 4 (2010)2010-06-10Radiologic Clinics of North America2010-06-10484S0033-8389(10)X0004-5799816http://www.radiologic.theclinics.com/article/PIIS0033838910000345/abstract?rss=yesCardiac computed tomography (CT) is a rapidly advancing technology that complements echocardiography in the imaging evaluation of congenital heart disease. CT can play an important role in diagnosis and follow-up via assessment of anatomic features and postoperative complications. An understanding of the pathophysiology and imaging characteristics of various congenital heart lesions is essential for effective implementation and accurate interpretation of the cardiac CT examination.Computed Tomography of Adult Congenital Heart DiseaseDouglas Hughes, Marilyn J. Siegel10.1016/j.rcl.2010.04.005Radiologic Clinics of North America 48, 4 (2010)2010-06-10Radiologic Clinics of North America2010-06-10484S0033-8389(10)X0004-5817835http://www.radiologic.theclinics.com/article/PIIS0033838910001314/abstract?rss=yesIndex10.1016/S0033-8389(10)00131-4Radiologic Clinics of North America 48, 4 (2010)2010-07-01Radiologic Clinics of North America2010-07-01484S0033-8389(10)X0004-5837842