Cardiac CT Atlas

Kohichiro Iwasaki
Takeshi MatsumotoContents
A. Significant Stenosis
B. High-Risk PlaqueC. Plaque Rupture
D. Plaque Progression and Regression
E. Coronary Artery Calcification
F. Coronary Artery Aneurysm and Ectasia
G. Coronary Stent

Contents
H. Coronary Artery Bypass Surgery
I. Anomalous Coronary ArteryJ. Embolic Stroke
K. Myocardial Infarction
L. Cardiac Valve
M. Congenital Heart Disease
N. Epicardial Fat

A. Significant Stenosis

1 Vessel Disease1 Vessel Disease (Tandem Lesion)

1 Vessel Disease2 Vessel Disease
RCALCX

3 Vessel Disease
RCA #2

RCA #3

LAD

LCX

B. High-Risk PlaquePositive RemodelingPositive RemodelingLow Attenuation PlaqueNapkin-RingSign

Napkin-Ring Sign

Napkin-Ring Sign

Napkin-Ring Sign

Napkin-Ring Sign

Napkin-Ring Sign

Napkin-Ring Sign

Napkin-Ring Sign

Napkin-Ring Sign

Napkin-Ring Sign

Positive Remodeling, Calcification

50-75% Stenosis, Positive RemodelingPositive Remodeling, Low Attenuation
PlaquePositive Remodeling, Low Attenuation
Plaque, Napkin-Ring Sign

50-75% Stenosis, Positive Remodeling,Low Attenuation Plaque50% Stenosis, Positive Remodeling,
Low Attenuation Plaque50% Stenosis, Positive Remodeling,
Low Attenuation PlaquePositive Remodeling, Low Attenuation
Plaque (-20HU)

50-75% Stenosis, Positive Remodeling,
Low Attenuation PlaquePositive Remodeling, Napkin-Ring Sign

50% Stenosis, Low Attenuation PlaqueTotal Occlusion, Positive Remodeling25% Stenosis, Positive Remodeling, Low
Attenuation Plaque, Napkin-Ring Sign

50%Stenosis, Positive Remodeling, Low
Attenuation Plaque, Napkin-Ring Sign

75% Stenosis, Positive Remodeling, LowAttenuation Plaque, Napkin-Ring Sign

C. Plaque RupturePlaque RupturePlaque RupturePlaque Disruption
Intra-Plaque Dye Penetration

Plaque Disruption
Intra-Plaque Dye Penetration

Plaque Disruption
Intra-Plaque Dye Penetration

Plaque Disruption
Intra-Plaque Dye Penetration

Plaque Disruption
Intra-Plaque Dye Penetration

D. Plaque Progression andRegression

Plaque Progression

Plaque Progression

Plaque Progression

2010/12/3
HDL-C 43
LDL-C 111
TG105

2011/11/4
HDL-C 39
LDL-C 59
TG128

Plaque Progression

Plaque Regression

2015/1/28

2016/1/20

Plaque Regression

2015/1/28

2016/1/20

Plaque Regression

2014/8/27

2015/9/2

200920112013

Plaque Regression

HDL-C 51mg/dl
LDL-C 80mg/dl
TG76mg/dl
2011/9/30

2012/10/11

Plaque Regression

2010/12/3

2011/11/4

E. Coronary Artery Calcification

Stent-like Calcification

Stent-like Calcification

Stent-like Calcification

Severe Calcification (CCS 10,110)

RCA

LAD

LCX

F. Coronary Artery Aneurysm
Coronary Artery Ectasia

Coronary Artery Aneurysm

Coronary Ectasia

G. Coronary Stent

Vision Stent

Cypher Stent

Taxus Stent

XPedition Stent

In-Stent Restenosis

H. Coronary Artery BypassGraft Surgery

CABG (LITA)

LITA

CABG (SVG)

CABG (SVG)

I. Anomalous Coronary ArteryCoronary-PA FistulaSingle Coronary ArteryAnomalous Coronary ArteryAnomalous Origin of RCAPARCA

AoPA

PAAo

AoPA

J. Embolic Stroke

LAA Thrombus

10 days later

LAA Thrombus: Early and Delayed

LAA/Ao 0.25

LAA Thrombus: Early and Delayed

LAA/Ao 0.18

Patent Foramen Ovale

Patent Foramen OvaleAortic Atheroma(Aortic Arch)Aortic Atheroma(Ascending Aorta)

Aortic Atheroma

Arterio-Venous Fistula of the Lung

Arterio-Venous Fistula of the Lung

K. Myocardial Infarction

Acute Myocardial Infarction

Old Myocardial Infarction

Non-contrast

Contrast

Delayed Enhancement

AMI-PCIDelayed Enhancement

acute phase

8 months laterL. Cardiac ValveNormal Aortic ValveNormal Aortic Valve Aortic Stenosis

diastolic phaseAortic Stenosis

diastolic phasesystolic phasediastolic phasesystolic phaseAortic Stenosis

diastolic phasesystolic phaseAortic Regurgitation

diastolic phasesystolic phasediastolic phasesystolic phaseNormal Mitral ValveMitral Valve Apparatus

Prosthetic ValveBioprosthetic Valvediastolic phasesystolic phaseM. Congenital Heart DiseaseAtrial Septal DefectAtrial Septal DefectN. Epicardial Fat

EFV 45ml

EFV 87ml

EFV 131ml

EFV 157ml

EFV 170ml

EFV 254ml

EFV 379ml