While the current primary clinical use of contrast-enhanced cardiac computed tomography (CCT) remains the exclusion of coronary artery disease in low to intermediate risk symptomatic patients, this modality offers a unique opportunity to assess both the pericardium and myocardium. Given the associated contrast and radiation exposure, CCT presently serves as an adjunct to echocardiography and cardiac MRI for this purpose. However, CCT provides superb delineation of the pericardium and can precisely localize lesions as well aid in their characterization. Further, CCT can effectively evaluate morphology and function in various myocardial diseases, including the various cardiomyopathies. The volumetric nature of image acquisition with CCT provides an accurate and reproducible method for quantifying ventricular mass, volumes, and function. This chapter will discuss the application of CCT in the assessment of various myocardial and pericardial disease processes.
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