1. CT ANGIOGRAPHY

2. CT IMAGE OF THE BLOOD VESSEL OPACIFIED BY CONTRAST

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

4. PATIENT PREP.

5. INFORMED CONSENT
                                         

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

9. UTILIZED

10. GAUGE SUITABLE FOR CTA
18 OR 20

11. CONTRAST ADMINISTERED WITH POWER INJECTOR

21. ACQUSITION PARAMETERS

22. 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.

23. SLICE THICKNESS
SPATIAL RESOLUTION
SLICE THICKNESS

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

25. SPIRAL PITCH
PITCH
SPATIAL RESOLUTION

26. SPIRAL PITCH
UP TO 2

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

28. RECONSTRUCTION INTERVAL
50% OF OVERLAP

29. UTILIZE SUBSECOND SCANNING
INCREASED TISSUE VOLUME COVERAGE
REDUCTION IN MOTION ARTIFACT

30. CONTRAST ADMINISTRATION

31. POWER INJECTOR

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

33. CONTRAST WARMER
WHY???

34. RATE OF INJECTION
3-5 ml/sec

35. ORAL CONTRAST????
WATER
NEGATIVE CONTRAST

36. AUTOMATED CONTRAST ADMINISTRATION SYSTEMS
SMARTPREP
CARE
SURESTART

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

38. CARE BOLUS
                                                                                            

39. SMART PREP
                            
                            

40.                                                             
SURE START

41. Bolus tracking- PE

42. PE?

43. Tracking slice

44. Bolus tracking- Carotids and Circle of Willis

46. Circle of Willis

47. Circle of Willis?!
40 SEC

48. Renal arteries sec.

50. ABDOMINAL AND FEMORAL RUNOFF

51. MANUAL DELAYS CERBRAL CTA CAROTID CTA CHEST CTA (PE) 15 SEC 12 SEC

52. CARDIAC CT

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

54. Prospectively ECG-Triggered Sequential Scanning Cardiac CT applications require the synchronization of data acquisition to the cardiac cycle, i.e. to the movement of the heart. For sequential imaging, a prospective trigger is derived from the ECG-trace to initiate the CT-scan with a certain delay time after the R-wave. The true delay time is calculated from a given phase parameter (e.g. a percentage of the RR-interval time) for each cardiac cycle individually based on a prospective estimation of the RR-intervals. Usually, the delay is defined such that the scans are acquired during the diastolic phase of the heart

55. Retrospectively ECG-Gated Spiral Scanning For "retrospectively ECG-gated spiral scanning" a continuous spiral scan is acquired with the ECG-signal recorded simultaneously. The acquired scan data is selected for image reconstruction with respect to a pre-defined cardiac phase. Similar to ECG-triggered sequential scanning a certain R-wave delay time defines the start point of data that is used for image reconstruction. ECG-gated spiral scanning has several advantages over ECG-triggered sequential scanning. The continuous acquisition allows for reconstruction of overlapping slices. Due to the retrospective analysis of the ECG, the technique is less sensitive to arrhythmia.

56. BOTH METHODS REQUIRE ECG MONITORING
DIASTOLIC PHASE

57. SCANNING DURING RR INTERVAL

58. Retrospective ECG-Gating                                                                                                                                                               

59. CARDIAC CT PROCEDURES
CARDIAC ANGIOGRAM
CALCIUM SCORING

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

61. CALCIUM SCORING
NO IV CONTRAST USED

62. CARDIAC ANGIOGRAM

63. CALCIUM SCORING

64. 3-D VISUALIZATION TOOLS IN CTA
MPR
MIP
SSD VR
CINE

65. CARDIAC ANGIOGRAM

66. CTA - MPR
PLANE?

67. MPR
PLANE?

68. MIP - CTA
                                                           

69. SSD -CTA

70. VR - CTA

71. CINE CTA

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

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

74. MIP CALCIFICATION DETECTION THROMBUS DETECTION AILIASING ARTIFACT
EDITING REQUIRED

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

76. STEREOSCOPIC VIEWING