Computed tomography for assessment of cardiac chambers, valves, myocardium and pericardium

Computed tomography (CT) introduced in 1973 revolutionized the practice of medicine and is the parent of diagnostic digital imaging. The heart is the only area for which conventional CT, spiral CT, and multidetector (MDCT) have not become a dominant modality for routine patient management. Limited temporal resolution remains the challenging reason, even though electron beam CT with 100 msec exposure times has been available for 2 decades. This article summarizes the feasibility of CT for evaluating myocardial disease, valvular heart disease and the pericardium, and discusses the current and future capability of MDCT for everyday cardiac diagnosis. Once millisecond CT becomes widely available, there is no reason why a quantitative evaluation of the heart including the coronary arteries and myocardial perfusion during stress cannot be performed as one comprehensive study.