Cardiac imaging has advanced to allow for detection of problems that often could have been done previously only with invasive surgery. Radiologists can detect abnormalities at an earlier stage and then collaborate with physicians in other subspecialties to provide minimally-invasive treatments where applicable.
Some Cardiac & Vascular Imaging Procedures Include:
An angiogram is an X-ray exam of the arteries and veins to diagnose blockages and other blood vessel problems. It can reveal the integrity of the cardiovascular system in specific areas throughout the body. Combined with the use of intravenous contrast medium injected via a catheter, an angiogram identifies areas of blockage or damaged vessels within the circulatory system. CT and MRI may also be used to gain additional images of the arteries.
Cardiac MRI is used to obtain detailed images of the heart. It helps physicians evaluate heart structures, such as the cardiac chambers and valves, major vessels and the pericardium (a small structure that surrounds the heart). Disorders such as coronary artery disease, irreversible scarring after a heart attack, tumors, infections, and inflammation can all be diagnosed and monitored using MRI. Physicians also use MRI to plan future patient’s treatment.
PET scans provide unique information on the metabolic functioning, rather than the structure, of the heart and other organs. Cardiac PET exams use tracer drugs to illuminate the area in question. A PET stress test can very accurately reveal complete or partial blockages to the arteries of the heart, enabling the patient to avoid an invasive catheterization in some cases.
This exam is part of a sophisticated high-speed CT exam of the heart. During the scan, which takes just seconds, the equipment measures the amount of calcium present and calculates a score. The lower the score, the lower the potential risk of an adverse future cardiac injury. (Calcium often covers the atherosclerotic plaque that builds up inside arteries. This plaque and calcium can lead to narrowing of the inside of the arteries which could in turn lead to an increased risk of angina, and a heart attack.) This test can assess coronary heart disease, which is often asymptomatic and is the most common cause of death for patients in the United States.
Cardiac nuclear medicine studies help physicians diagnose the cause and exact location of chest pain and visualize blood flow patterns to the heart (myocardial perfusion scan), scan for heart attack damage, assess the heart post-surgery (bypass or re-vascularization), and see the heart-wall movement (in conjunction with an electrocardiogram, or ECG).
A nuclear “stress test” takes images of your heart at rest and after your heart has been “stressed.” The two are compared to reveal if there is any damage to your heart muscle. This procedure helps evaluate coronary artery disease, acute chest pain, hibernating myocardium and cardiomyopathies. Initially, you will be injected with an isotope, and (30 minutes later) resting images will be acquired. The stress portion is next, which involves either a treadmill or injection of medications that mimic physiological stress. A second isotope is injected for this portion of the test. After your heart rate returns to normal and you eat, the technologist takes the final set of images of your heart.
Vascular ultrasound uses sound waves to image the body’s veins and arteries. A special ultrasound technique, called Doppler, evaluates blood flow through vessels in the abdomen, arms, legs, neck and head. It helps the physician find tumors, congenital malformations, narrowing (as with plaque accumulation), and blocks (as with deep-vein thrombosis). It also helps clinicians assess the health of the arteries before or after a procedure, i.e., to judge whether an angioplasty is advisable or if a graft is succeeding.