64 msct angiography & 64 cardiac msct · 2016. 5. 24. · 64 msct angiography • non invasive...
TRANSCRIPT
![Page 1: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/1.jpg)
Cardiosurgery - Skopje
64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT
Special hospital for surgery diseases
“Filip II”
Lidija Veljanovska, MD
May, 2009
![Page 2: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/2.jpg)
Cardiosurgery - Skopje
64 MSCT ANGIOGRAPHY
• Non invasive procedure,
comfortable for the patient
• Great spatial and temporal
resolution,slice thickness - 0,625
mm (provide excellent details
that allow identification of
vascular anomalies and different
pathological entities)
• 3D post-processing
• Method of choise for emergency
cases
(dissection,trauma)
![Page 3: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/3.jpg)
Cardiosurgery - Skopje
64 MSCT ANGIOGRAPHY - INDICATIONS
• Vascular anomalies
• Trauma-rupture, stenosis, occlusion
• Pathological vascularisation of the tumors
• Aneurysmatical disease and dissection of the aorta
• Aneurysmatical disease of intracranial vessels
• Planing - interventions, stenting or vascular surgery
• Postinterventional follow up (grafts, stents)
![Page 4: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/4.jpg)
Cardiosurgery - Skopje
![Page 5: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/5.jpg)
Cardiosurgery - Skopje
Congenital anomalies, coarctaction
![Page 6: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/6.jpg)
Cardiosurgery - Skopje
Abdominal Aorta – Infrarenal Aneurysm
![Page 7: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/7.jpg)
Cardiosurgery - Skopje
Thoracoabdominal aneurysm
![Page 8: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/8.jpg)
Cardiosurgery - Skopje
Dissection
Stanford A
Dissection
Stanford B
![Page 9: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/9.jpg)
Cardiosurgery - Skopje
![Page 10: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/10.jpg)
Cardiosurgery - Skopje
Carotid arteries
![Page 11: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/11.jpg)
Cardiosurgery - Skopje
Carotid arteries
![Page 12: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/12.jpg)
Cardiosurgery - Skopje
![Page 13: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/13.jpg)
Cardiosurgery - Skopje
Intracranial vessels
![Page 14: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/14.jpg)
Cardiosurgery - Skopje
Intracranial vessels
![Page 15: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/15.jpg)
Cardiosurgery - Skopje
Syndrome LericheCT
Angiography of
the Lower
Extremities
![Page 16: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/16.jpg)
Cardiosurgery - Skopje
• Cardiac CT has a role in the
management of patients especially
with atypical angina
• To provide an accurate diagnosis
we need:
• High image quality
• Efficient post processing
• Clinical expertise
64 Cardiac MSCT
Clinical impact & indication
![Page 17: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/17.jpg)
Cardiosurgery - Skopje
64 CARDIAC MSCT - Indications
• Detection of CAD for a patient with
atypical chest pain/ angina
• Screening in asymptomatic patients
with high risk for CAD
• Evaluation of suspected coronary
anomalies before/after cath lab
• Coronary assessment before cardiac
& vascular surgery
• Planning of interventions - stenting
• Stent & CABG follow up
• Triple rule out ( aortic
dissection,PE,CAD)
• Evaluation of valvular and
ventricular function
![Page 18: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/18.jpg)
Cardiosurgery - Skopje
Calcium Scoring Index
![Page 19: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/19.jpg)
Cardiosurgery - Skopje
64 Cardiac MSCT
![Page 20: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/20.jpg)
Cardiosurgery - Skopje
Congenital anomalies
of coronary arteries
![Page 21: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/21.jpg)
Cardiosurgery - Skopje
![Page 22: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/22.jpg)
Cardiosurgery - Skopje
Real length of the stenosis,
suggested stent size and positioning
![Page 23: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/23.jpg)
Cardiosurgery - Skopje
Coronary by-pass grafts
To evaluate each graft, proximal & distal anastomosis, run off & non grafted coronary artery
![Page 24: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/24.jpg)
Cardiosurgery - Skopje
Arterial by-pass grafts:
The most frequent left internal mammary artery (LIMA).
revascularizes the LAD and the diagonal arteries.
![Page 25: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/25.jpg)
Cardiosurgery - Skopje
Arterial by-pass grafts:
![Page 26: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/26.jpg)
Cardiosurgery - Skopje
Aorto-coronary grafts , the proximal anastomosis is located on the antero-lateral
wall of the supra –coronary ascending aorta
Venous grafts are prone to progressive atherosclerotic changes due to
arterialization with consequences on the long term patency results.
![Page 27: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/27.jpg)
Cardiosurgery - Skopje
![Page 28: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/28.jpg)
Cardiosurgery - Skopje
64 CARDIAC MSCT
Causes of failure:
• Heart rate > 70bpm
• High Arrhythmia
• Patient cooperation
(breathing)
• High level of calcium
scoring
• Careful with:
– Renal insufficiency
– Hyperthireosis
![Page 29: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/29.jpg)
Cardiosurgery - Skopje
64 Cardiac MSCT
- Ichemia or necrosis area.
- Atrial & Ventricular
septal defect
- Anevrysm or false
anevrysm
- Thrombus or tumor
formation
- Pericardial effusion &
califications
- valvular evaluation
- Ejection fraction
![Page 30: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/30.jpg)
Cardiosurgery - Skopje
64 Cardiac MSCT
![Page 31: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/31.jpg)
Cardiosurgery - Skopje
Distal PLB occlusion +
Infero basal aneurysm
![Page 32: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/32.jpg)
Cardiosurgery - Skopje
Right aortic arch, pulmonary isthmus stenoses, ASD,
VSD
![Page 33: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/33.jpg)
Cardiosurgery - Skopje
Dissection Stanford A
![Page 34: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/34.jpg)
Cardiosurgery - Skopje
64 Cardiac MSCTAneurysmatical disease
![Page 35: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/35.jpg)
Cardiosurgery - Skopje
![Page 36: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/36.jpg)
Cardiosurgery - Skopje
64 Cardiac MSCT
Pulmonary emboli
![Page 37: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/37.jpg)
Cardiosurgery - Skopje
64 Cardiac MSCT pulmonary carcinoma
![Page 38: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/38.jpg)
Cardiosurgery - Skopje
64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT
Compiclations:
• Adverse reactions to contrast agents (prophylactic treatment )
• Extravasation of contrast material
(Compartment syndrome )
Renal insufficiency induced by contrast material may be prevented by ensuring adequate hydration
![Page 39: 64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT · 2016. 5. 24. · 64 MSCT ANGIOGRAPHY • Non invasive procedure, comfortable for the patient • Great spatial and temporal resolution,slice](https://reader036.vdocuments.us/reader036/viewer/2022070213/610cf23b30ebab3f2565aa79/html5/thumbnails/39.jpg)
Cardiosurgery - Skopje
CONCLUSION
64 MSCT ANGIOGRAPHY & 64 Cardiac MSCT :
Noninvasive, fast, precise, safe, without absolute contraindications
Compared to catheter angiography more patient-friendly procedure.
Decrease the number of diagnostic conventional angiography