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Coronary CT angiography

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different cycles to generate one complete image. The advantage of this method is that each image segment is acquired in less time as compared to acquiring the entire heart in one heart cycle, thus improving temporal resolution. The disadvantages are 1) the potential for image artifacts from fusing the image segments and 2) the requirement of additional X-ray radiation for image acquisition.
211:), although newer acquisition protocols, have recently been developed which drastically reduce this exposure to around 1 mSv (cfr. Pavone, Fioranelli, Dowe: Computed Tomography or Coronary Arteries, Springer 2009). By comparison, a chest X-ray carries a dose of approximately 0.02-0.2 mSv and natural 286:
The latest MSCT scanners acquire images only at 70-80% of the R-R interval (late diastole). This prospective gating can reduce effective dose from 10 to 15 mSv to as little as 1.2 mSv in follow-up patients acquiring at 75% of the R-R interval. Effective dose using MSCT coronary imaging can
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In this technique, a portion of the heart is imaged during one heart cycle while an ECG trace is recorded. During the next heart cycle, the next portion of the heart is scanned for up to 5 total cycles until the entire heart is imaged. The reconstruction algorithm then combines the images from these
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The significance of the low radiation doses used in diagnostic imaging is unknown, although the possibility of increasing cancer incidence across a population is of significant concern. This potential risk must be weighed against the competing risk of not diagnosing a significant health problem in a
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is around 93%. This means for every 100 patients who appear to have coronary artery disease after CT angiography, 18 of them actually won't have it, and that for every 100 patients who have a negative CT angio test result (i.e. the test says they do not have coronary artery disease), 7 will actually
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In addition to the diagnostic abilities, cardiac CTA beholds important prognostic information. Stenosis severity and extent of coronary artery disease are important prognostic indicators. However, one of the unique features of cardiac CTA is the fact that it enables the visualization of the vessel
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have the disease as defined by the reference standard of invasive coronary angiography via cardiac catheterization. Both coronary CT angiography and invasive angiography via cardiac catheterization yield similar diagnostic accuracy when both are being compared to a third reference standard such as
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is around 2.3 mSv/year. Thus, each cardiac CT scan carried out with current protocols (dose approximately 1 mSv) is equivalent to approximately 5-50 chest X-rays or less than 1 year of background radiation. Methods are available to decrease this exposure, however, such as prospectively decreasing
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With the advent of subsecond rotation combined with multi-slice CT (up to 320 slices), high resolution and high speed can be obtained at the same time, allowing excellent imaging of the coronary arteries (cardiac CT angiography). Images with even higher temporal resolution can be obtained using
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by acquiring a full CT slice in only half a rotation, thus reducing motion blurring at high heart rates and potentially allowing for shorter breath-hold time. This is particularly useful for ill patients having difficulty holding their breath or unable to take heart-rate lowering medication.
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The speed advantages of 64-slice MSCT have rapidly established it as the minimum standard for newly installed CT scanners intended for cardiac scanning. Manufacturers have developed 320-slice and true 'volumetric' scanners, primarily for their improved cardiac scanning performance.
663:"Ionizing radiation in cardiac imaging: a science advisory from the American Heart Association Committee on Cardiac Imaging of the Council on Clinical Cardiology and Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention" 159:. At present, it appears that the greatest utility of cardiac CT lies in ruling out coronary artery disease rather than ruling it in. This is because the test is highly sensitive (over 90% detection rate), so a negative test result largely rules out 216:
radiation output based on the concurrently acquired ECG (i.e. tube current modulation.) This can result in a significant decrease in radiation exposure, at the risk of compromising image quality if there is any arrhythmia during the acquisition.
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Feuchtner, G.; Loureiro, R.; Bezerra, H.; et al. (2012). "Quantification of coronary stenosis by dual source computed tomography in patients: a comparative study with intravascular ultrasound and invasive angiography".
444:"CT Angiography for the Prediction of Hemodynamic Significance in Intermediate and Severe Lesions: Head-to-Head Comparison With Quantitative Coronary Angiography Using Fractional Flow Reserve as the Reference Standard" 387:"Diagnostic Accuracy of CT Coronary Angiography According to Pretest Probability of Coronary Artery Disease and Severity of Coronary Arterial Calcification: The CorE-64 International, Multicenter Study" 283:
Introduction of a CT scanner with a 160 mm detector in 2014 allows for imaging of the whole heart in a single beat without motion of the coronary arteries, regardless of patient heart rate.
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Arbab-Zadeh, Armin; Miller, Julie M; Rochitte, Carlos E; Dewey, Marc; Niinuma, Hiroyuki; Gottlieb, Ilan; Paul, Narinder; Clouse, Melvin E.; Shapiro, Edward P. (2012-01-24).
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Motoyama S, et al. (Jun 2009). "Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome".
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wall, in a non-invasive manner. Therefore, the technique is able to identify characteristics of coronary artery disease that are associated to the development of
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Because the heart is effectively imaged more than once (described above), cardiac CT angiography can result in a relatively high radiation exposure (around 12
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Min JK, et al. (Aug 2011). "Age- and Sex-Related Differences in All-Cause Mortality Risk Based on Coronary Computed Tomography Angiography Findings".
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very practical in a number of clinical settings. The faster capability has allowed the imaging of the heart with minimal involuntary motion, which creates
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Gerber TC, Carr JJ, Arai AE, Dixon RL, Ferrari VA, Gomes AS, Heller GV, McCollough CH, McNitt-Gray MF, Mettler FA, Mieres JH, Morin RL, Yester MV (2009).
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on the image, and has a number of practical applications. It may be useful in the diagnosis of suspected coronary heart disease, for follow-up of a
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is used, severe contrast agent allergy, uncontrolled hyperthyroidism or renal function impairment are also relative contraindications.
2498: 2359: 2035: 1940: 1533: 1412: 1152: 1061: 2240: 991: 167:). The test is somewhat less specific, however, so a positive result is less conclusive and may need to be confirmed by subsequent 1698: 976: 971: 854: 2247: 2054: 1056: 1039: 90: 2347: 2044: 1417: 1264: 1164: 1147: 342: 2493: 2369: 1543: 1397: 996: 871: 863: 762: 1870: 2354: 2342: 2223: 1654: 1588: 1520: 1510: 1488: 1259: 1227: 858: 229: 2469: 1691: 1318: 1286: 1269: 1392: 1127: 867: 1994: 2301: 2191: 1945: 1735: 1633: 1301: 1291: 179: 175: 164: 2488: 2380: 2364: 1831: 1814: 1672: 1623: 1402: 1281: 1254: 1015: 800: 755: 306:"Prognostic Value of Coronary CT Angiography and Calcium Score for Major Adverse Cardiac Events in Outpatients" 184: 156: 125: 2376: 2318: 2218: 2183: 2029: 1571: 1407: 1348: 1333: 1222: 196: 188: 160: 118: 2422: 1628: 1442: 1311: 1242: 1049: 149: 17: 2453: 2257: 2178: 1306: 1237: 1103: 986: 905: 812: 245: 102: 2427: 1984: 1797: 1792: 1649: 1338: 1276: 1098: 212: 168: 358:
Mikolich, JR (May 2012). "Cardiac computed tomographic angiography and the primary care physician".
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Heart smart a cardiologist's 5-step plan for detecting, preventing, and even reversing heart disease
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Budoff, M.; Nakazato, R.; Mancini, G.B.; Gransar, H.; Leipsic, J.; Berman, D.S.; Min, J.K. (2016).
272: 2289: 2202: 2198: 2144: 2139: 2080: 2001: 1909: 1858: 1772: 1583: 1432: 1427: 1328: 1211: 1066: 817: 241: 141: 639: 305: 2332: 2278: 2208: 2116: 2104: 1965: 1955: 1950: 1853: 1804: 1715: 1422: 1387: 1382: 1323: 1071: 920: 733: 684: 612: 571: 536: 501: 465: 424: 406: 367: 338: 114: 50: 2432: 2337: 2075: 2005: 1988: 1920: 1893: 1888: 1360: 1249: 1108: 880: 832: 723: 715: 674: 602: 563: 528: 493: 455: 414: 398: 1683: 2404: 2326: 2173: 2163: 2149: 2040: 2010: 1916: 1745: 1730: 1458: 910: 876: 849: 844: 778: 704:"What are the basic concepts of temporal, contrast, and spatial resolution in cardiac CT?" 94: 152:, for the evaluation of valvular heart disease and for the evaluation of cardiac masses. 2311: 2296: 2092: 2069: 1900: 1884: 1819: 1600: 728: 703: 419: 386: 268: 237: 679: 662: 304:
Zhi-hui Hou; Bin Lu; Yang Gao; Shi-liang Jiang; Yang Wang; Wei Li; Matthew J. Budoff.
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Use of computed tomography angiography to assess the coronary arteries of the heart
232:. The potential harms to a fetus include the application of X-rays in addition to 2390: 2133: 2097: 1777: 1762: 1538: 1093: 925: 915: 895: 885: 827: 822: 791: 497: 249: 228:
Pregnancy is considered a relative contraindication, similarly to many forms of
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Faster CT machines, due to multidetector capabilities, have made imaging of the
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Journal of the American College of Cardiology Cardiovascular Imaging
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average less than the dose in conventional coronary angiography.
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multi-cycle (also called multi-segmental) image reconstruction.
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in determining the risk of Major Adverse Cardiac Events (MACE).
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Image of contrast enhanced dual-source coronary CT-angiograph
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It is uncertain whether this modality will replace invasive
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particular individual, such as coronary artery disease.
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The Journal of the American Osteopathic Association
61: 49: 32: 330: 109:and then the heart is scanned using a high speed 1699: 763: 708:Journal of Cardiovascular Computed Tomography 391:Journal of the American College of Cardiology 324: 322: 8: 178:of cardiac CTA is approximately 82% and the 271:scanners, introduced in 2005, allow higher 1758: 1741:Cardiology diagnostic tests and procedures 1706: 1692: 1684: 1493: 1375: 1365: 961: 805: 796: 770: 756: 748: 38: 1837:Transcatheter pulmonary valve replacement 727: 678: 606: 459: 418: 18:Coronary computed tomographic angiography 1880:shunt from heart chamber to blood vessel 1606:Orthogonal polarization spectral imaging 1980:shunt from blood vessel to blood vessel 296: 252:may result in a reduced image quality. 29: 2110:Valve-sparing aortic root replacement 1849:enlargement of existing septal defect 7: 1844:production of septal defect in heart 91:computed tomography (CT) angiography 589:Versteylen MO, et al. (2013). 72: 1941:transposition of the great vessels 1866:creation of septal defect in heart 1413:Sestamibi parathyroid scintigraphy 25: 2241:Cardiac resynchronization therapy 680:10.1161/CIRCULATIONAHA.108.191650 2465: 2464: 1668: 1667: 2248:Left atrial appendage occlusion 1170:Cholangiopancreatography (MRCP) 117:, usually in order to diagnose 1418:Radioactive iodine uptake test 1: 2370:Radionuclide ventriculography 1398:Radionuclide ventriculography 872:Lower gastrointestinal series 864:Upper gastrointestinal series 702:Lin, E.; Alessio, A. (2009). 486:European Journal of Radiology 236:. Since an iodine-containing 213:background radiation exposure 2355:Myocardial perfusion imaging 1589:Optical coherence tomography 1511:Myocardial perfusion imaging 1099:Dental panoramic radiography 230:medical imaging in pregnancy 89:(CTA or CCTA) is the use of 498:10.1016/j.ejrad.2010.12.008 329:DeVane, Matthew S. (2006). 2515: 1962:for univentricular defect 1393:Ventilation/perfusion scan 868:Small-bowel follow-through 720:10.1016/j.jcct.2009.07.003 630:Hart, D; Wall B F (2002). 608:10.1016/j.jacc.2013.02.065 568:10.1016/j.jacc.2009.02.068 533:10.1016/j.jacc.2011.02.074 461:10.1016/j.jcmg.2015.08.021 403:10.1016/j.jacc.2011.06.079 163:(i.e. the test has a high 101:. The patient receives an 2499:X-ray computed tomography 2462: 2302:Implantable loop recorder 1946:Arterial switch operation 1736:Interventional cardiology 1726: 1663: 1634:Dynamic angiothermography 1378: 1302:Abdominal ultrasonography 808: 180:negative predictive value 176:positive predictive value 165:negative predictive value 73: 37: 2381:Coronary catheterization 1871:Blalock–Hanlon procedure 1832:Mitral valve replacement 1815:Aortic valve replacement 1624:Non-contact thermography 1403:Radionuclide angiography 1255:Doppler echocardiography 337:. Hoboken, N.J.: Wiley. 185:intravascular ultrasound 157:coronary catheterization 126:coronary CT calcium scan 2377:Cardiac catheterization 2319:Electrophysiology study 2219:Radiofrequency ablation 2184:Alcohol septal ablation 1408:Radioisotope renography 197:acute coronary syndrome 189:fractional flow reserve 161:coronary artery disease 119:coronary artery disease 87:Coronary CT angiography 33:Coronary CT angiography 2423:Impedance cardiography 2045:Coronary artery bypass 1443:Gastric emptying study 246:coronary artery stents 150:coronary artery bypass 2454:Transcutaneous pacing 2258:Heart transplantation 2179:Ventricular reduction 1995:Blalock–Taussig shunt 1104:X-ray motion analysis 987:X-ray microtomography 906:Hysterosalpingography 813:Pneumoencephalography 103:intravenous injection 2494:Diagnostic radiology 2428:Ballistocardiography 1985:systemic circulation 1629:Contact thermography 1339:Emergency ultrasound 1277:Transcranial Doppler 1028:Abdominal and pelvis 169:invasive angiography 2307:Cardiac stress test 2285:Electrocardiography 2224:Pacemaker insertion 1971:Kawashima procedure 1935:compound procedures 1810:Aortic valve repair 1783:Mitral valve repair 1596:Confocal microscopy 1474:Indium-111 WBC scan 1297:Echoencephalography 1033:Virtual colonoscopy 642:on October 19, 2013 273:temporal resolution 256:Improved resolution 242:Cardiac arrhythmias 124:CTA is superior to 2360:Cardiovascular MRI 2290:Vectorcardiography 2145:Pericardial window 2140:Pericardiocentesis 2081:Drug-eluting stent 1910:Rastelli procedure 1859:Balloon septostomy 1584:Optical tomography 1433:Dacryoscintigraphy 1428:Immunoscintigraphy 1067:Whole body imaging 818:Dental radiography 142:circulatory system 2476: 2475: 2333:Angiocardiography 2279:Electrophysiology 2266: 2265: 2209:Catheter ablation 2192:Conduction system 2117:LeCompte maneuver 2105:Bentall procedure 1966:Norwood procedure 1956:Senning procedure 1951:Mustard procedure 1854:Atrial septostomy 1805:Valve replacement 1681: 1680: 1643:Target conditions 1566: 1565: 1562: 1561: 1482: 1481: 1423:Bone scintigraphy 1388:Scintimammography 1383:Cholescintigraphy 1228:contrast-enhanced 1122: 1121: 1082: 1081: 1072:Full-body CT scan 972:General operation 951: 950: 921:Angiocardiography 601:(22): 2296–2305. 595:J Am Coll Cardiol 556:J Am Coll Cardiol 521:J Am Coll Cardiol 224:Contraindications 115:coronary arteries 95:coronary arteries 84: 83: 63:OPS-301 code 16:(Redirected from 2506: 2468: 2467: 2433:Cardiotocography 2401: 2365:Ventriculography 2338:Echocardiography 2329: 2281: 2197:Maze procedure ( 2194: 2160: 2136: 2089: 2088:Obstacle removal 2076:Bare-metal stent 2072: 2032: 1989:pulmonary artery 1981: 1936: 1921:pulmonary artery 1894:Fontan procedure 1889:pulmonary artery 1881: 1845: 1759: 1708: 1701: 1694: 1685: 1671: 1670: 1494: 1376: 1366: 1250:Echocardiography 1109:Hounsfield scale 962: 881:Cholecystography 806: 797: 772: 765: 758: 749: 742: 741: 731: 699: 693: 692: 682: 658: 652: 651: 649: 647: 638:. 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318: 295: 294: 292: 289: 269:Dual Source CT 257: 254: 238:contrast agent 225: 222: 204: 201: 133: 130: 93:to assess the 82: 81: 74: 71: 70: 65: 59: 58: 53: 47: 46: 43: 35: 34: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 2511: 2500: 2497: 2495: 2492: 2490: 2487: 2486: 2484: 2471: 2461: 2455: 2452: 2450: 2449:Cardioversion 2447: 2446: 2444: 2440: 2434: 2431: 2429: 2426: 2424: 2421: 2420: 2418: 2416: 2412: 2406: 2403: 2400: 2396: 2395: 2392: 2389: 2387: 2384: 2382: 2378: 2375: 2371: 2368: 2367: 2366: 2363: 2361: 2358: 2356: 2353: 2349: 2346: 2344: 2341: 2340: 2339: 2336: 2334: 2331: 2328: 2324: 2323: 2320: 2317: 2313: 2310: 2309: 2308: 2305: 2303: 2300: 2298: 2295: 2291: 2288: 2287: 2286: 2283: 2280: 2276: 2275: 2273: 2269: 2259: 2256: 2254: 2251: 2249: 2246: 2245: 2242: 2239: 2236: 2233: 2230: 2227: 2225: 2222: 2220: 2217: 2215: 2212: 2210: 2207: 2204: 2200: 2196: 2193: 2189: 2188: 2185: 2182: 2180: 2177: 2175: 2172: 2170: 2169:Dor procedure 2167: 2165: 2162: 2159: 2155: 2154: 2151: 2148: 2146: 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repair 1763:Heart valves 1650:Acute stroke 1616:Thermography 1371:scintigraphy 1361:Radionuclide 1349:pre-hospital 1195:Tractography 1114:Radiodensity 1044: 1020: 1016:calcium scan 977:Quantitative 711: 707: 697: 670: 666: 656: 646:December 30, 644:. 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Index

Coronary computed tomographic angiography

ICD-9-CM
87.41
OPS-301 code
3-224
edit on Wikidata
computed tomography (CT) angiography
coronary arteries
heart
intravenous injection
radiocontrast
CT scanner
coronary arteries
coronary artery disease
coronary CT calcium scan
heart
circulatory system
motion blur
coronary artery bypass
coronary catheterization
coronary artery disease
negative predictive value
invasive angiography
positive predictive value
negative predictive value
intravascular ultrasound
fractional flow reserve
acute coronary syndrome
millisievert

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