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Details of Coronary CT Angiography

Coronary CT angiography has attained increasing scientific attention at academic institutions and has become a highly accurate diagnostic modality. Extending this knowledge into a practice setting is the purpose of "Coronary CT Angiography". This book will assist you in integrating cardiac CT into your daily practice, while also giving an overview of the current technical status and applications. The specific features of scanners from all four main vendors are also presented providing an objective overview of noninvasive coronary angiography using CT.

How to perform & Risk factors-

This procedure use intravenous dye which contains iodine and CT scanning to image the coronary arteries. While the use of catheters is not necessary (thus the term "noninvasive" test applies to this procedure), there are still some risks involved. In people allergic to iodine, pretreatment with medications is necessary to prevent allergic reactions to the dye. In people with abnormal kidney function and/or diabetes, the dye may worsen kidney function. Finally, there is radiation exposure which is similar to, if not greater than, that received with a conventional coronary angiogram. Nonetheless, this is generally a very safe test for most people, but should only be undergone when ordered by a physician familiar with the patient and their underlying medical condition.

Who should get a CT coronary angiogram?

While CT angiography should not be used as a "screening" test in the general population, it is a major new tool in the diagnosis of coronary artery disease. In patients at high risk for developing coronary disease (cigarette smokers, those with genetic risk, high cholesterol levels, hypertension, or diabetes), who have unclear results with treadmill or other testing, or who have symptoms suspicious of coronary disease, CT angiography is an excellent next step in the diagnosis. If the CT scan is normal or only mildly abnormal, it makes the likelihood of a severe blockage of the coronary arteries extraordinarily small. Conversely, if the CT scan is significantly abnormal, cardiac catheterization and angiography are then indicated, to see if angioplasty, stenting, or coronary bypass surgery may be indicated.

In people who have had bypass surgery, CT angiography is very effective at evaluating the patency of the bypass grafts. In people who have had coronary stents , it is sometimes difficult to image the inside of the stent to see if it is narrowed. Due to these complexities, while CT coronary angiography is an exciting new modality, it is imperative to discuss with your physician if this is the correct test for you. As more experience is obtained, the indications for the test will become even clearer.

Applications-

Multislice computed tomography (MSCT) is an additional potential tool for the assessment of coronary artery disease. It can provide information about stenoses in coronary arteries and coronary artery bypass grafts, ventricular size and function, cardiac structure and masses, pulmonary vein anatomy, myocardial perfusion and coronary artery plaque. In this review the recent developments in CT technology that have made cardiac imaging possible are examined and the benefits of the latest 64-slice and dual-source CT scanners explained. Information on how to perform cardiac CT and evidence for its various clinical applications are given. Problems and limitations of cardiac CT and the radiation dose are discussed. Future developments and the likely impact of this rapidly evolving technique on clinical cardiology are considered.