mdct coronary
TRANSCRIPT
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ROLE OF MDCT CARDIAC CT AND CORONARY CTA IN DIAGNOSIS OF CARDIAC PATIENTS.
BY: DR. TALAAT KHATER, M.SC.
RADIOLOGY SPECIALIST
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A PIECE OF WISDOM.
•The coronary CTA is used to rule out
rather than to rule in the presence of
obstructive coronary artery disease.
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CARDIAC CTA VS CARDIAC CATH.Better strategies rather than cardiac cath. are needed for risk stratification in routine clinical practice.Prof. Patel, et al. NEJM march 2010.
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A HINT OF BASICS (HOW IT IS POSSIBLE)• Rapid, continuous and complex movement.• Short cardiac cycle.• Respiratory movement.• Patient compliance. Development of MDCT made it possible.
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SINGLE SLICE VS MULTISLICE CT SCANNERS
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AVAILABLE MULTISLICE CT SCANNERS• 4 MDCT.• 16 MDCT.• 40 MDCT.• 64 MDCT (Minimum).• 64 MDCT HR.• 128 MDCT • 128 dual source scanners.• 256 and 320 MDCT.
Scan time
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ECG GATING
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• Intermediate risk.• Negative predictive value (95-99%).• Positive predictive value (80-85%).• Patient factors: -
• Cooperative.• HR.• Rhythm.
CRITERIA OF PATIENT SELECTION
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PATIENT PREPARATION• Creatinine level.• No exercise.• Beta blockers.• Nitroglycerine. • Fasting.• Proper training.• Stop drugs of erectile dysfunction and caffeine.
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APPLICATIONS OF CTA• Calcium scoring (risk stratification).• Obstructive coronary lesions.• Stent evaluation.• CABG (graft evaluation).• Others. • TAVI.
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CALCIUM SCORING• Atherosclerosis and CAC.• Negative predictive value.• Correlated to age and gender.• Risk assessment (risk stratification). • Agatston ca score and volume score.
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NORMAL CTA CORONARY
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OBSTRUCTIVE CORONARY DISEASE
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STENT AND GRAFT SURVEILLANCE
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OTHER DETECTABLE PROBLEMS BY CTA• Chamber.• Valvular.• Shunts.• Congenital anomalies.• Lung and pulmonary vessels.
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TO CONCLUDE
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