Radiographic techniques Chest radiography

In critical care, the chest radiograph is extremely helpful in the assessment of many cardiac disorders including heart failure with pulmonary congestion, pleural effusions, and pulmonary embolism. It is also used to assess the position and integrity of catheters, pacing electrodes, or artifical heart valves. Fluoroscopy, i.e. the real-time display of X-ray images on image intensifiers, may be used to confirm floating electrodes as a cause of pacemaker dysfunction and to assess the dynamic motion of prosthetic valves when prosthetic dysfunction is suspected.

X-ray computed tomography

X-ray CT generates transaxial images of X-ray absorption and provides better spatial resolution than standard X-ray imaging. In cardiovascular imaging, CT imaging permits assessment of large vascular structures and has the capability of measuring vessel size and detecting dissecting membranes, calcific plaques, or large thrombi.

Angiography

Angiography involves the selective or subselective intravascular injection of a contrast medium to generate single images or image sequences of intraluminal dimensions. With the use of thin catheters and non-ionic contrast media, arterial angiography, including coronary angiography, is a safe procedure with very few severe complications. Quantitative coronary angiography uses digital image processing to measure vessel diameter at stenotic and unobstructed coronary segments and to quantify the severity of coronary stenoses

Left anterior oblique (LAO) view of a coronary angiogram demonstrating a severe coronary stenosis located in the proximal portion of the left anterior descending artery and also involving a large diagonal branch (panel B). Quantitative coronary angiography panels B and C) permits measurement of vessel diameters in an unobstructed reference segment (3.45 mm) and within the stenotic segment (0.85 mm), and thus allows calculation of the severity of stenosis (94 per cent area stenosis).

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