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CT Cardiac Master I

1) CT cardiac is an effective non-invasive method for exploring the coronary arteries. It can be used to visualize coronary anatomy, atherosclerotic plaques, stents, bypass grafts, and functional parameters like ejection fraction and wall motion. 2) The document outlines the protocol for a CT cardiac exam, including preparation of the patient, EKG gating, contrast injection details, and reconstruction techniques. 3) Examples are provided of CT findings like obstructive coronary artery disease, anomalous coronary arteries, calcified plaques, soft plaques, and mixed plaques. CT can also be used to evaluate transcatheter aortic valve implantation.

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Andreea Roman
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163 views45 pages

CT Cardiac Master I

1) CT cardiac is an effective non-invasive method for exploring the coronary arteries. It can be used to visualize coronary anatomy, atherosclerotic plaques, stents, bypass grafts, and functional parameters like ejection fraction and wall motion. 2) The document outlines the protocol for a CT cardiac exam, including preparation of the patient, EKG gating, contrast injection details, and reconstruction techniques. 3) Examples are provided of CT findings like obstructive coronary artery disease, anomalous coronary arteries, calcified plaques, soft plaques, and mixed plaques. CT can also be used to evaluate transcatheter aortic valve implantation.

Uploaded by

Andreea Roman
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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CT CARDIAC

•Dr. Loredana Popa


Anatomie
Anatomie

CD

CX
IVP CX
RPL
CD
IVP
RPL
IVP
RPL

Dominanta dreapta- RCA Dominanta stanga -CX Codominanta- CX, RCA


Introducere

• Coronarografia invaziva- gold standard


• CT cardiac
 metoda alternativa
 neinvaziva
 timp de achizitie scurt
 rezolutie spatiala si temporala buna
CT cardiac - indicatii

 Boala coronariana ischemica


Criterii de includere- excludere

 simptomatici
 probabilitate pretest mica/medie pentru boala
coronariana
 factori de risc
 fara modificari EKG, teste enzimatice negative, test de
efort negativ/neconcludent
 suspiciune de anomalie coronariana
CT cardiac - indicatii

• Excludere placi ATS – suspiciune de BCI


• Analiza paci ATS: localizare, compozitie, grad de
stenoza
• Anomalii ale arterelor coronare
• evaluarea stenturilor endovasculare la pacientii cu
suspiciune de restenozare
• Analiza by-pass
• Evaluare stenoza de valva aortica- TAVI
• Vene pulmonare
MDCT Cardiac

Scanner Used Siemens Sensation 64


KV/ mAs 120/ 850

Detector Collimation (mm) 0.6

Slice thickness (mm) 0.75


Pitch 0.2

Reconstruction interval 0.4

Image order (acquisition) Cr-ca


Oral contrast N/A

80ml Omnipaque 350


IV contrast volume and type 40 ml ser - chaser
Injection rate 7ml/sec
bolus tracking
Scan delay (sec) 6 sec delay
3D technique used VRT/ MIP
CT cardiac- protocol

• Pregatire pacient: B blocant!


• Sincronizare EKG
100 %

25 % 70 %

Sistola Diastola
CT Cardiac

• Topograma (512 mm)


• FOV (180 mm)
• TAP→ diafragm
• Cranio-caudal
CT cardiac- protocol

• Nativ- Scor de calciu- AGATSTON


CT Cardiac

• Trigger Ao asc=100 HU
• Debit= 7 ml/s
• Cor CTA= 64x0,6 mm
• EKG gating
• Timp : 20s

achizitie
• Artefacte
vizualizare multi faza MPR
analiza functionala

coronary mapping 3D
MIP, VRT
CT Cardiac

•ax scurt • 2 camere •4 camere


CT Cardiac

• corect • incorect
CT cardiac -placi ATS

placa ATS complet calcificata


CT cardiac -placi ATS
CT cardiac -placi ATS

placa ATS moale


CT cardiac -placi ATS

placa ATS mixta


CT cardiac -placi ATS
CT cardiac -anomalii

• Origine
CT cardiac -anomalii

•a •b
CT cardiac -anomalii

•PLV

•PD
A

•L
A •L
M
D
•L
A
D
CT cardiac -anomalii

•TA
P •TAP

•Arterial
branch
CT cardiac -
anomalii

• punte
miocardica

•D1
CT cardiac -
anomalii

•Aorta

LM
CT cardiac -anomalii
CT cardiac -stent
CT cardiac : By-pass
CT cardiac –studiu functional
Caz 1
• ♂, 60 ani, rasa alba
• Scor de calciu 28.1
(5.40mg/cm3)

• percentilele 25 si 50
Caz 2
C.G. sex ♂
73 ani
Stenoze semnificative tricoronariene
Scor de calciu 2129,5 (> percentila 95
pt rasa, varsta si sex)
Fractie de ejectie 41%.
CD
Caz 3
•Controlul bypass-ului
STENOZA DE VALVA AORTICA-TAVI
TAVI
Concluzii

CT cardiac:
 metoda neinvazica eficienta in explorarea patului
coronarian
 anatomie
 placi ATS
 stent
 by-pass
 explorari functionale( fractie de ejectie; motilitate parietala)
 TAVI
Va multumesc.

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