Clinical role of advanced imaging in cardiology |
The last decade has seen an unprecedented development
in imaging technologies that are able to noninvasively
characterize cardiovascular conditions. At the
forefront of these modalities have been cardiovascular
magnetic resonance (CMR) and multidetector computed
tomography angiography (MDCTA). Linked to
advances in software and hardware, current CMR
scanners are able to provide a comprehensive evaluation
of the cardiac patient with a range of information
on anatomy, function, perfusion, viability, tissue characterization,
flow patterns, as well as coronary and
vascular angiography. MDCTA is able to provide accurate
characterization of coronary luminal stenosis
and plaque burden in a short scan, frequently avoiding
the need for subsequent x-ray angiography with its
attendant risks and complications—particularly in
the intermediate risk group. Developments in echocardiography
have enabled better tissue characterization,
real-time three-dimensional visualization, and, using
specific contrast agents, assessment of myocardial
perfusion. Tissue Doppler techniques have facilitated
better understanding of myocardial mechanics—
particularly useful, eg, in assessment of dyssynchrony.
In this review article we provide a brief overview of
how these techniques work and discuss current and
future applications. We highlight the strengths, as
well as limitations, of these imaging modalities, and
discuss when to consider these tests in clinical practice...
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