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New Dual Source 64 Slice CT Scan Revolutionizes Cardiac Imaging
Robert D. Lyon, M.D., Radiologist, Columbia St. Mary’s
Posted: March 1, 2007
Taking better pictures of the heart for diagnostic purposes has been a long-time pursuit among cardiologists and radiologists. Now, physicians at Columbia St. Mary’s Hospital have the first dual source, 64-slice computed tomography (CT) machine in Southeastern Wisconsin. The new machine’s speed is an important advance in diagnostic cardiology, as the technology is twice as fast compared to other CT machines and captures high resolution images of a beating heart in seconds without the need for heart slowing medications.
In the cardiac field, CT scanning has many uses. Most commonly, CT scanning has been used for cardiac calcium scoring, a procedure used to find and identify the extent of calcium buildup in the coronary arteries from atherosclerosis, or hardening of the arteries. Because there is a direct correlation between the amount of calcium buildup and the risk for heart attack, cardiac calcium scoring can be an early indicator of heart disease. More recently, however, cardiac care professionals have begun using CT scanning as a non-invasive method of coronary angiography, a procedure used to identify the narrowing of coronary arteries, a condition that indicates the presence of significant heart disease.
The most recent studies of CT coronary angiography have demonstrated up to 99 percent accuracy in diagnosing heart disease when compared with the gold standard, cardiac catheterization. Cardiac CT angiography is not used in lieu of a coronary angiogram, but is a highly accurate diagnostic test for patients with significant risk factors, in their mid-40’s to 60’s, to determine likelihood of heart disease. For those patients who receive a positive test after undergoing CT coronary angiography, and the disease is not severe enough to warrant immediate treatment, a trip to a cardiologist is in order. In this situation, a cardiologist may order a nuclear stress test before deciding the course of treatment to determine if the disease detected by CT is severe enough to limit blood flow to heart muscle during exercise. This additional information is used in combination with the coronary CT findings to decide on the best course of care.
CT coronary angiography is also a promising triage tool for determining if patients presenting to the emergency room with undiagnosed chest pain, and no obvious signs of heart disease or blockages based on standard blood tests or ECG, are having a heart attack. A CT coronary angiogram can be performed and if it shows minimal or no coronary artery disease, the patient can be safely discharged and the need for hospitalization and further testing is eliminated.
The dual source 64 slice CT is also beneficial for:
- determining heart disease in patients who have or may have inconclusive cardiac stress test results
- obese patients who are difficult to image with less powerful CT scanners
- identification or follow-up of congenital heart abnormalities
- preoperatively for some electrophysiology patients and high risk surgical patients who may have heart disease
It’s important to note that CT studies have not replaced coronary angiograms; however, their use is growing and many doctors use the CT images to confirm the need for a coronary angiogram or are used in conjunction with an angiogram.
For those patients where a problem is detected, CT scanning provides more diagnostic certainty than traditional non-invasive cardiology testing, and much of the guesswork is taken out of deciding the most effective course of treatment, which is of great benefit for patients and physicians.
Robert D. Lyon, M.D.
Radiologist
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