Imaging techniques in cardiology 1: echocardiography, CT, MRI, SPECT
1. Big picture
Cardiac imaging answers four exam questions:
- Structure: chamber size, hypertrophy, valves, pericardium, masses → mainly echocardiography, also cardiac magnetic resonance imaging (CMR) and cardiac computed tomography (CT).
- Function: ejection fraction, wall motion, diastolic function, right ventricular function → echocardiography first, CMR most accurate for volumes.
- Coronary anatomy: stenosis, coronary anomalies, calcium → coronary CT angiography (CCTA).
- Perfusion/ischemia/viability: is myocardium underperfused but alive? → stress echo, SPECT, stress CMR, PET.
Modern chronic coronary syndrome workup is risk-based: pre-test probability guides whether to use CCTA, stress imaging, or invasive coronary angiography. Non-invasive imaging such as CCTA, myocardial perfusion imaging, and CMR is used to improve diagnosis and reduce unnecessary invasive procedures. ([European Society of Cardiology][1])
Core exam idea: Echo = first-line bedside functional test. CT = coronary/aortic anatomy. MRI = myocardial tissue characterization. SPECT = perfusion and ischemia.
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