Abstract
Cardiac computed tomography (CT) has become a valuable tool in the equipment of the cardiologist. Many technological advances in CT have occurred recently, including dual-energy CT (DECT) or spectral CT. CT is now considered a reliable tool to assess coronary artery stenosis, but it still has two main areas for improvement. Firstly, difficult estimation of the degree of stenosis in the presence of calcified plaque; secondly, CT needs to be improved in correctly identifying plaque components. Spectral CT permits accurate plaque characterization, assessment of myocardial perfusion, acute myocarditis, non-ischemic dilated cardiomyopathy, determining if shadowing inside a stent is an artifact or restenosis, better delineation of aortic stent graft endoleaks, detection of both acute and chronic pulmonary embolisms. Also, lower contrast and radiation doses of 50-60% and even 90% in some studies. Currently, both transesophageal ultrasound (TEE) and CT evaluations are necessary before AF ablation. The TEE evaluation reveals that the cardiac thrombi and multislice CT anatomic reconstructions of the left atrium and pulmonary veins guide the isolation procedure.
