MDCT coronary and cardiac CT overview

1. ROLE OF MDCT CARDIAC CT AND
CORONARY CTA IN DIAGNOSIS OF
CARDIAC PATIENTS.
BY:
DR. TALAAT KHATER, M.SC.
RADIOLOGY SPECIALIST

2. A PIECE OF WISDOM.
•The coronary CTA is used to rule out
rather than to rule in the presence of
obstructive coronary artery disease.

3. 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.
Better strategies rather than cardiac cath. are needed for
risk stratification in routine clinical practice.
Prof. Patel, et al. NEJM march 2010.

4. 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.

5. SINGLE SLICE VS MULTISLICE CT SCANNERS

6. 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.
Scantime

7. ECG GATING

8. • Intermediate risk.
• Negative predictive value (95-99%).
• Positive predictive value (80-85%).
• Patient factors: -
• Cooperative.
• HR.
• Rhythm.
CRITERIA OF PATIENT SELECTION

9. PATIENT PREPARATION
• Creatinine level.
• No exercise.
• Beta blockers.
• Nitroglycerine.
• Fasting.
• Proper training.
• Stop drugs of erectile dysfunction and caffeine.

10. APPLICATIONS OF CTA
• Calcium scoring (risk stratification).
• Obstructive coronary lesions.
• Stent evaluation.
• CABG (graft evaluation).
• Others.
• TAVI.

11. CALCIUM SCORING
• Atherosclerosis and CAC.
• Negative predictive value.
• Correlated to age and gender.
• Risk assessment (risk stratification).
• Agatston ca score and volume score.

12. NORMAL CTA CORONARY

13. OBSTRUCTIVE CORONARY DISEASE

14. STENT AND GRAFT SURVEILLANCE

15. OTHER DETECTABLE PROBLEMS BY CTA
• Chamber.
• Valvular.
• Shunts.
• Congenital anomalies.
• Lung and pulmonary vessels.

16. TO CONCLUDE