Cardiac CT 64 Slice Angiography
This is a procedure performed using a multi-slice CT. The current multi-slice CT that exquisitely produces coronary artery images, is a 64-slice CT scanner.
This scanner has a special x-ray tube and rotation speed, capable of performing 3 rotations in a second. In each rotation, 64-slices are produced, giving us approximately 194 slices per second. This is the fastest scanner in the industry, currently. Speed is extremely important in the ability to "freeze" the heart. Since the heart is a rapidly moving structure, the only way to image structures within it, is if we can scan as fast as the heart beats or close enough.
All scans are gated to the ECG trace. This allows to position the data acquisition accurately in specific phases.
Using This Modality The Following Procedures Can Be Performed As Part Of A Cardiac CT Examination :-
- Calcium scoring
- Coronary artery imaging ( CT Coronary Angiography)
- Functional assessment
The Applications Of Cardiac CT Include The Following : -
- Detection and characterization of coronary artery occlusive lesions secondary to atherosclerosis, transplant arteriopathy, intimal dissection and vasculitis
- Detection and characterization of coronary artery anomalies
- Detection and characterization of coronary artery aneurysms
- Coronary vein mapping
- Characterization of cardiac chamber morphology and function
- Characterization of native and prosthetic cardiac valves
- Detection and characterization of congenital heart disease
- Characterization of cardiac masses
- Diagnosis of pericardial diseases
- Detection and characterization of post-operative abnormalities
Who Should Get A Cardiac CT Done ?
The Following Are Situations In Which A Cardiac CT Is Of Use : -
"To Rule Out Coronary Artery Disease "
The ability of cardiac CT to rule out coronary artery disease exceeds a predictive value of 99%. This means that when the study is reported to be normal, it will be normal. This makes it a more accurate test than stress-testing, stress-echocardiography, stress-thallium and stress-perfusion MRI. More importantly, the heart does not have to be stressed to get this information.
"To Rule Out Coronary Artery Disease" Is An Issue That Often Arises In The Following Situations : -
The Patient is Asymptomatic :
-(i.e. there are no problems, such as chest pain or breathlessness, but coronary artery disease needs to be ruled out)
- Family history of coronary artery disease
- Persistent high triglyceride levels and other high risk factors such as smoking, diabetes, etc.
- ECG abnormalities on a routine health check-up
- Equivocal (plus/minus) abnormalities on a routine stress test, done prior to employment, insurance or as part of a routine health check-up
- Moderate to severe hypertension
- Prior to non-coronary surgery in the adult population, etc
- Pre-ASD repair
- Pre-valvular repair
- Pre-tumor surgery
Other Indications For Cardiac CT Test : -
- Cardiac CT is an excellent tool for assessing the status of bypass grafts.
- For stents larger than 3mm in size, cardiac CT is an excellent tool for assessing in-stent lumen. For stents smaller than 2.5mm, the results are still equivocal.
- Cardiac CT is a good tool for assessing cardiac neoplasms
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