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Questions and Answers
What is the main purpose of CT coronary angiography?
What is the main purpose of CT coronary angiography?
Which benefit does CT coronary angiography provide aside from detecting coronary artery disease?
Which benefit does CT coronary angiography provide aside from detecting coronary artery disease?
What aspect of coronary anatomy does CT coronary angiography illustrate?
What aspect of coronary anatomy does CT coronary angiography illustrate?
Which statement accurately describes a potential limitation of CT coronary angiography?
Which statement accurately describes a potential limitation of CT coronary angiography?
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In what way does CT coronary angiography differ from traditional coronary angiography?
In what way does CT coronary angiography differ from traditional coronary angiography?
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Which of the following is an indication for CT coronary angiography?
Which of the following is an indication for CT coronary angiography?
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What is a significant indication for CT coronary angiography in relation to surgical procedures?
What is a significant indication for CT coronary angiography in relation to surgical procedures?
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Which of these conditions is NOT a typical indication for CT coronary angiography?
Which of these conditions is NOT a typical indication for CT coronary angiography?
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Which of the following does NOT represent an indication for performing CT coronary angiography?
Which of the following does NOT represent an indication for performing CT coronary angiography?
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Which of the following statements about the indications for CT coronary angiography is true?
Which of the following statements about the indications for CT coronary angiography is true?
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Study Notes
CT Coronary Angiography
- Purpose (Morphology): Detects and analyzes coronary artery disease, depicting coronary artery anatomy. Also assesses myocardial function in the same scan.
- Purpose (Function): Measures myocardial contractility and valve morphology/function, assessing myocardial viability.
- Indications: Evaluates suspected pulmonary embolism, aortic disease, pericardial disease, cardiac masses, and pre-surgical heart surgery (especially before redo open-heart surgery), and pulmonary veins. Also used for patients with low-to-intermediate chest pain and suspected coronary artery anomalies or complex congenital heart disease, or assessing graft patency after bypass surgery.
- Contraindications: Pregnancy, clinical instability, insufficient renal function, and a history of anaphylactic contrast reaction.
Patient Preparation
- Medications: Patients should take cardiac medications as usual. Nitrate and beta-blocker contraindications should be checked.
- Diet: No food 3–4 hours before the scan. No caffeine for 12 hours.
- Other: Instructions on breathing, ECG signal acquisition, and heart rate control are necessary.
Prospective ECG Method
- Purpose: Captures high-quality heart images with minimal motion artifacts, synchronized with ECG. Specific points in the cardiac cycle (mid-to-end diastole) are used.
- Advantages: Lower radiation exposure, short scan period, and high-quality diagnostic images without needing the complete cardiac cycle.
- Limitations: Requires a regular sinus rhythm, less effective for patients with high heart rates or arrhythmias; patient weight should be under 100kg.
Retrospective ECG GATED Method
- Purpose: Used when heart rate control is difficult or additional information about ventricular/valvular function is needed.
- Procedure: Images are acquired continuously throughout the entire cardiac cycle, and the best image is selected from the different phases.
- Advantages: Provides information about heart function in patients with irregular heart rates or high heart rates.
- Disadvantages: Higher radiation exposure.
Contrast Injection
- Biphasic Injection: Used to evaluate the RCA and for functional analysis. Used to opacify the right ventricle.
- Triphasic Injection: Used to maintain dense opacification for coronaries and the left ventricle, and good opacification improvement to the right ventricle.
Post-Processing Techniques
- Techniques: Multiplanar reformats (MPR), maximum intensity projections (MIP), volume rendering (VR), curved reformats, and cine imaging.
Calcium Score
- Purpose: Useful risk stratification tool for coronary artery disease. Also is better than other risk assessment methods when it comes to cardiovascular events and death prediction.
- Scoring: Calcium density is assessed, from 1 to 4.
- Limitations: Irregular heart rates and obesity limit the value of the procedure's usefulness.
CT Anatomical Planes of the Heart
- Planes: Vertical long axis, short axis views, three-chamber view, and four-chamber (or horizontal long axis).
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Description
This quiz covers CT Coronary Angiography, focusing on its purposes, indications, contraindications, and patient preparation. Learn how this imaging technique aids in diagnosing coronary artery disease and assessing myocardial function. Test your knowledge on the appropriate use of CT angiography in various cardiac evaluations.
