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CT ANGIOGRAPHY. CT IMAGE OF THE BLOOD VESSEL OPACIFIED BY CONTRAST.

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Presentation on theme: "CT ANGIOGRAPHY. CT IMAGE OF THE BLOOD VESSEL OPACIFIED BY CONTRAST."— Presentation transcript:

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 –1.2 mg/dl IODINE ALLERGY- STEROID THERAPY HYPERVENTILATION BEFORE EXAM FOR BETTER BREATHOLD

7

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9 UTILIZED

10 GAUGE SUITABLE FOR CTA 18 OR 20

11 CONTRAST ADMINISTERED WITH POWER INJECTOR

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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

24 CEREBRAL CTA ABDOMINAL CTA THORACIC CTA 1MM (LOWER mA) 3MM SLICE THICKNESS

25 SPIRAL PITCH PITCHSPATIAL 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

45

46 Circle of Willis

47 Circle of Willis?! 40 SEC

48 Renal arteries sec.

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50 ABDOMINAL AND FEMORAL RUNOFF

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


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