CT ANGIOGRAPHY PowerPoint Presentation

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CT ANGIOGRAPHY

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CT IMAGE OF THE BLOOD VESSEL OPACIFIED BY CONTRAST

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REQUIREMENTS FOR CTA PATIENT PREPARATION ACQUSITION PARAMETERS CONTRAST MEDIUM ADMINISTRATION POSTPROCESSING TECHNIQUES

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PATIENT PREP.

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INFORMED CONSENT

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PATIENT PREP. BUN 7-20 mg/dl CREAT.- 0.6 –1.2 mg/dl IODINE ALLERGY- STEROID THERAPY HYPERVENTILATION BEFORE EXAM FOR BETTER BREATHOLD

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UTILIZED

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GAUGE SUITABLE FOR CTA 18 OR 20

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CONTRAST ADMINISTERED WITH POWER INJECTOR

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ACQUSITION PARAMETERS

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PARAMETERS USUALLY ROUTINE CT PRECEDES A CTA EXAM. THE ROUTINE EXAM IS USED AS A REFERENCE SCAN HELPING TO DETERMING THE SCANNING RANGE IN CTA.

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SLICE THICKNESS SLICE THICKNESS SPATIAL RESOLUTION

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CEREBRAL CTA ABDOMINAL CTA THORACIC CTA 1MM (LOWER mA) 3MM 3MM SLICE THICKNESS

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SPIRAL PITCH PITCH SPATIAL RESOLUTION

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SPIRAL PITCH UP TO 2

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kVp, mA, TIME SIMILAR TO NON- CTA EXAM OF THE SAME BODY PART

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RECONSTRUCTION INTERVAL 50% OF OVERLAP

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UTILIZE SUBSECOND SCANNING INCREASED TISSUE VOLUME COVERAGE REDUCTION IN MOTION ARTIFACT

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CONTRAST ADMINISTRATION

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POWER INJECTOR

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POWER INJECTOR PARAMETERS VOLUME OF CONTRAST-ml RATE ml/sec TIME OF INJECTION – sec SCAN DELAY TIME - sec

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CONTRAST WARMER WHY???

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RATE OF INJECTION 3-5 ml/sec

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ORAL CONTRAST???? WATER NEGATIVE CONTRAST

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AUTOMATED CONTRAST ADMINISTRATION SYSTEMS SMARTPREP CARE SURESTART

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CONTRAST ADMINISTRATION AND SCANNING METHODS BOLUS TRACKING BOLUS TIMING MANUAL PRESET TIME

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CARE BOLUS

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SMART PREP

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SURE START

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Bolus tracking- PE

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PE?

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Tracking slice

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Bolus tracking- Carotids and Circle of Willis

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Circle of Willis

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Circle of Willis?! 40 SEC

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Renal arteries 25-30 sec.

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ABDOMINAL AND FEMORAL RUNOFF

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MANUAL DELAYS CERBRAL CTA CAROTID CTA CHEST CTA (PE) 15 SEC 12 SEC 10-20 SEC

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CARDIAC CT

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TWO TECHNIQUES TO REDUCE MOTION ARTIFACTS IN CARDIAC CT PROSPECTIVE TRIGGERING RETROSPECTIVE GATING

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BOTH METHODS REQUIRE ECG MONITORING DIASTOLIC PHASE

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SCANNING DURING RR INTERVAL

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CARDIAC CT PROCEDURES CARDIAC ANGIOGRAM CALCIUM SCORING

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CARDIAC ANGIOGRAM PERFORMED WITH CONTRAST INJECTION 4-5 cc/sec 150 cc total volume

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CALCIUM SCORING NO IV CONTRAST USED

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CARDIAC ANGIOGRAM

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CALCIUM SCORING

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3-D VISUALIZATION TOOLS IN CTA MPR MIP SSD VR CINE

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CARDIAC ANGIOGRAM

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CTA - MPR PLANE?

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MPR PLANE?

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MIP - CTA

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SSD -CTA

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VR - CTA

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CINE CTA

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MPR SIMPLE FAST ANY PLANE VISUALIZATION LESS USEFUL IN COMPLEX VESSEL VISUALIZATION

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SSD FAST LITTLE EDITING LITTLE AXIAL DATA USAGE CONTOUR , RELATIONSHIP OF VESSELS ARTIFACT GENERATION INACCURATE

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MIP CALCIFICATION DETECTION THROMBUS DETECTION AILIASING ARTIFACT EDITING REQUIRED

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VR ACCURATE ALL DATA USED GOOD STENOSIS DETECTION COMPLEX COMPUTER PROCESSING (PAST)

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STEREOSCOPIC VIEWING