cardiac ct how i do it september 2011
DESCRIPTION
CT cardiaccoronary how to readcoronairsclerosisatherosclerosisradiologyTRANSCRIPT
![Page 1: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/1.jpg)
Coronary CTHow I do it
![Page 2: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/2.jpg)
![Page 3: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/3.jpg)
Patient selection
• Risk factors• Medium - high risk -> angio suite• Low - medium -> CT (exclude
disease)
![Page 4: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/4.jpg)
Patient selection
• Pre-op evaluation• Post CABG
![Page 5: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/5.jpg)
Calcium score
• Risk calculation (MESA %)• Check RCA motion• 1 minute• Stop if zero or high
![Page 6: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/6.jpg)
Pro / retrospective
• Prospective - SAS - lower dose– sharper image
• Retrospective - higher dose– function / motion
![Page 7: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/7.jpg)
![Page 8: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/8.jpg)
Checklist
• Skin / breast• Bone• Lung• Mediastinum• Abdomen
![Page 9: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/9.jpg)
Checklist
• Skin / breast - mass• Bone - fracture / lesion• Lung - node• Mediastinum - hernia• Abdomen - organs, mesentery, fluid
• Heart
![Page 10: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/10.jpg)
Breast / skin - Biopsy
Harish, Radiographics 2007
![Page 11: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/11.jpg)
Bone - MRI
radiology.casereports.net
radiopaedia
![Page 12: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/12.jpg)
Lung
• <4mm = 0%• 4-7mm = 1%• >8mm =
15%• >20mm =
75%
Stacy, Radiographics 2010
![Page 13: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/13.jpg)
Fleischner < 8 mm
• Solitary node• New• No history of cancer• Smoker?• CT: 6 / 12 … months
![Page 14: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/14.jpg)
![Page 15: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/15.jpg)
Mediastinum
• Hernia
Pickhardt, AJR 2011
![Page 16: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/16.jpg)
Mediastinum
• Lymph node
Koyama, Radiographics 2004
![Page 17: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/17.jpg)
Abdomen
• Mesentery
Lucey, Radiographics 2005
![Page 18: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/18.jpg)
Abdomen
• Fluid
Lucey, Radiographics 2005
![Page 19: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/19.jpg)
![Page 20: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/20.jpg)
![Page 21: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/21.jpg)
Go with the flow
• VC - RA - RV - PA• PV - LA - LV - Aorta
![Page 22: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/22.jpg)
Heart 1
• Vena cava - reflow• RA - abnormal pulmonary vein /
ASD• RV - VSD• PA - enlarged, embolus
![Page 23: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/23.jpg)
Vena cava
• Reflow
Hani, AJR 2002
![Page 24: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/24.jpg)
Martinez - Jimenez, Radiographics 2010
![Page 25: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/25.jpg)
![Page 26: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/26.jpg)
![Page 27: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/27.jpg)
![Page 28: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/28.jpg)
Martinez - Jimenez, Radiographics 2010
Left vena cava to LA
![Page 29: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/29.jpg)
Right Atrium
• ASD
emedicine
![Page 30: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/30.jpg)
Right Ventricle
• VSD
Khanna, AJR 2004
![Page 31: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/31.jpg)
Pulmonary artery
• Embolism
Wittram, Radiographics 2004
![Page 32: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/32.jpg)
Pulmonary artery
• Embolism
Wittram, Radiographics 2004
![Page 33: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/33.jpg)
Pulmonary artery
• Embolism
Wittram, Radiographics 2004
![Page 34: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/34.jpg)
Heart 2
• Pulmonary veins - stenosis / anomaly
• LA - thrombus (auriculum)• LV - infarct, aneurysm• Aorta - diameter• Valves - mass, calcium• Pericardium - fluid, thick
![Page 35: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/35.jpg)
Pulmonary vein
• Stenosis
Cronin, AJR 2004
![Page 36: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/36.jpg)
Pulmonary vein
• Stenosis
Cronin, AJR 2004
![Page 37: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/37.jpg)
Pulmonary vein
• PV to VC
Cronin, AJR 2004
![Page 38: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/38.jpg)
Pulmonary vein
• PV to VC
Cronin, AJR 2004
![Page 39: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/39.jpg)
Left Atrium
• Membrane
Dillman, AJR 2009
![Page 40: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/40.jpg)
Left Atrium
• Membrane
Dillman, AJR 2009
![Page 41: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/41.jpg)
Left Atrium
• Thrombus
Dillman, AJR 2009
• Myxoma
![Page 42: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/42.jpg)
Left Ventricle
• Aneurysm
Bruzzi, AJR 2006
![Page 43: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/43.jpg)
Left Ventricle
• Thrombus
Bruzzi, AJR 2006
![Page 44: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/44.jpg)
Aorta
• Diameter• Wall
Cronin, AJR 2004
![Page 45: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/45.jpg)
Aorta
• Diameter• Wall
Cronin, AJR 2004
![Page 46: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/46.jpg)
Valves - normal Aortic valve
Vogel, Radiographics 2006
![Page 47: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/47.jpg)
Bicuspid Aortic valve
Vogel, Radiographics 2006
![Page 48: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/48.jpg)
Calcified Pannus
Vogel, Radiographics 2006
![Page 49: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/49.jpg)
Calcified Pannus
Vogel, Radiographics 2006
![Page 50: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/50.jpg)
Pericardium
• Thin
Wang, Radiographics 2003
![Page 51: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/51.jpg)
Pericardium
• Thin
Wang, Radiographics 2003
![Page 52: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/52.jpg)
Pericardium
• Fluid
Wang, Radiographics 2003
![Page 53: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/53.jpg)
Pericardium
• Fluid
Wang, Radiographics 2003
![Page 54: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/54.jpg)
Coronary
![Page 55: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/55.jpg)
Coronary
• Anatomy• Dominance (inferior wall)• RCA• LM• LAD• CX
![Page 56: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/56.jpg)
LAD
RCA Cx
![Page 57: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/57.jpg)
Normal
Sundaram, AJR 2009
![Page 58: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/58.jpg)
Malignant
Sundaram, AJR 2009
![Page 59: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/59.jpg)
Malignant
Sundaram, AJR 2009
A P
![Page 60: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/60.jpg)
Benign
Sundaram, AJR 2009
![Page 61: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/61.jpg)
Bridging
Sundaram, AJR 2009
![Page 62: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/62.jpg)
![Page 63: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/63.jpg)
LAD - septum
RCA - inferior
CX - lateral
Vascular territory
![Page 64: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/64.jpg)
LAD
RCA
CX
![Page 65: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/65.jpg)
LAD
RCA
CX
![Page 66: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/66.jpg)
LAD
RCA
CX
![Page 67: Cardiac ct how i do it september 2011](https://reader035.vdocuments.us/reader035/viewer/2022062418/556372bcd8b42ae6088b55b3/html5/thumbnails/67.jpg)