Rajiah, Prabhakar

Vascular abnormalities are significant and often underdiagnosed conditions that can have profound implications for athletic performance, limb function, and even life, and multimodality imaging plays an essential role in timely recognition, characterization, and management.

Single ventricle is a rare congenital heart defect involving one functional ventricle, and imaging is essential for classification, functional assessment, anomaly detection, and guiding management.

Coronary CT angiography (CCTA) offers excellent negative predictive value for ruling out obstructive coronary artery disease (CAD); however, several interpretative pitfalls can lead to diagnostic errors including false-negative, false-positive results or inaccurate estimation of degree of stenosis. These errors may influence patient management, prompt unnecessary or missed downstream testing, and ultimately affect clinical outcomes. This two-part article reviews the most common sources of diagnostic inaccuracy in CCTA through case-based examples. Part I highlights factors that contribute to missed or overdiagnosed coronary lesions while Part II focuses on pitfalls that lead to underestimation or overestimation of stenosis severity and outlines practical strategies to mitigate these errors. Recognizing the inherent limitations of CCTA and employing a systematic, structured interpretive approach are essential for preserving its high diagnostic accuracy and ensuring optimal patient care.

Accurate quantification of coronary stenosis on coronary CT angiography (CCTA) is essential for appropriate risk stratification and clinical decision-making, yet several technical and interpretative pitfalls can compromise diagnostic accuracy. This second part of a two-part review examines common factors that lead to overestimation or underestimation of stenosis severity, with attention to how these errors influence CAD-RADS categorization, downstream testing, and patient management. Using case-based examples, we describe key contributors to misinterpretation and present practical strategies to mitigate these pitfalls. By recognizing these nuances and employing a structured, standardized interpretive approach, readers can minimize errors in stenosis assessment and enhance the reliability of CCTA as a noninvasive tool for evaluating coronary artery disease.

The cardiac imager should be familiar with the types of motion artifacts commonly encountered in cardiac CT, some of which can be corrected or at least minimized without having to rescan the patient.

Renovascular hypertension is the most common cause of secondary hypertension, and radiologist awareness of the various imaging appearances and various causes is crucial for accurate diagnosis and guiding treatment.

Alcohol use disorder is linked to a multitude of diseases and disorders, many of which can be diagnosed with imaging techniques such as US, CT, and MRI, enabling early detection and potentially preventing further damage and improving outcomes.

Photon-counting detector CT offers improved assessment of small stents and higher diagnostic accuracy than conventional CT through enhanced spatial resolution and spectral reconstructions.