In evaluation of the heart, the primary role of conventional computed tomography (CT) has been to exclude other abnormalities, such as aortic dissection, that may secondarily affect cardiac function. Because of excellent anatomic resolution, CT is also useful in depicting paracardiac disease processes that involve the myocardium.
Advantages of CT examination of myocardial structures include good resolution of 0.1 to 0.5 mm 2 and rapid imaging times of 5 min or less for the chest. The low-density epicardial fat usually provides excellent contrast to the higher density of the cardiac structures. Calcifications, present at the site of ventricular aneurysms, of the coronary arteries or of atherosclerotic change, are easily depicted. With the advent of helical CT scanners, a full three-dimensional (3D) set of images is obtained, allowing multiplanar reconstruction and 3D viewing. Although conventional CT scanners provide only one image slice each 2 to 5 s, helical CT is increasingly available to emergency departments (EDs). Helical CT and spiral CT are synonyms for the same rapid mode of CT scanning, and are described in more detail below.
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