Actual patient ECG saved

Clinical Background

• 54-year-old male patient (90kg weight) with known risk factors presented a left bundle-branch block during a stress test.

• This block appeared earlier in the ECG cycle than during a stress test two years prior.

• A Cardiac CT exam was recommended to further examine the coronary arteries as well as the rest of the of the mediastinum for any heart disease.

Click on the images to enlarge

		The Angiographic view in MIP and in VR clearly demonstrates the distal branches of the different coronary arteries and the collateral branches
Curved View (1) and X-Section (2) views showing the calcified plaque on the LAD	Left Circumflex artery and its collateral branches	Right Coronary artery and its proximal portion of the posterior descending artery and lateral branch

Diagnosis

• Normal aspect of the right coronary artery, the left marginal branch, the diagonal branches of the left coronary artery, and the left circumflex artery.

• Small amount of calcification on the LAD first segment but with no significant stenoses.

• Normal aspect of the entire mediastinum and of the heart valves. The left ventricular ejection fraction is also normal.

• This is a negative study for any significant flow-limiting disease, no significant calcium or soft plaques seen in the coronary tree, and no coronary anomalies seen. Follow-up cardiac catheterization determined not to be needed due to negative coronary CTA.

Scan Technique

• Detector Configuration: 64 x 0.625 mm at 40 mm coverage per rotation

• Total Scan Time: 5.3 sec

• Rotation Speed: 0.35 sec

• Pitch: 0.2:1

• Scan Coverage: 124 mm

• Contrast: 90 ml @ 5 cc/sec, 40 ml of contrast @ 3 cc/sec flush + 40 ml of saline flush @ 2 cc/sec

VCT Benefits

• A shorter acquisition for a shorter breath hold and a stable heart rate during the whole acquisition.

• Better visualization of the distal branches and the thin collateral branches.

• Acquisition during pure arterial phase (no venous contamination).

Prepared by:
Olivier Adda
CT Cardiac Imaging Advanced Application Specialist

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