State of the art of coronary computed tomography angiography |
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Institution: | 1. Diagnostic Radiology Department, American University of Beirut Medical Center, P.O. Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon;2. American University of Beirut, P.O. Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon;1. Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark;2. Orthopedic Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark;3. Biomechanics and Imaging Group (BIG), Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands;4. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark;1. Clinical Center University of Sarajevo, Department of Radiology, Bolnička 25, 71000, Sarajevo, Bosnia and Herzegovina;2. Sarajevo School of Science and Technology, Hrasnička cesta 3a, 71210, Ilidža, Bosnia and Herzegovina;1. Ryhov County Hospital, SE-551 85 Jönköping, Sweden;2. Department of Clinical Physiology, Linköping University, SE-581 83 Linköping, Sweden;3. Center of Medical Image Science and Visualization, Linköping University, SE-581 83 Linköping, Sweden;4. Faculty of Medicine and Health, School of Health Science, Örebro University, SE-701 82 Örebro, Sweden;1. College of Applied Medical Sciences, Taibah University, Medina, 42353, Saudi Arabia;2. School of Health and Society, University of Salford, Salford, M5 4WT, United Kingdom;3. Oslo Metropolitan University, Faculty of Health Sciences, Norway;4. Department of Oncology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Radiumhospitalet, Oslo, Norway |
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Abstract: | ObjectivesThe aim of this paper is to evaluate contrast media (CM) bolus geometry and opacification patterns in the coronary arteries with particular focus on patient, scanner and safety considerations during coronary computed tomography angiography (CCTA).Key findingsThe rapid evolution of computed tomography (CT) technology has seen this imaging modality challenge conventional coronary angiography in the evaluation of coronary artery disease. Increases in spatial and temporal resolutions have enabled CCTA to become the modality of choice when evaluating the coronary vascular tree as an alternative in the diagnostic algorithm for acute chest pain. However, these new technologic improvements in scanner technology have imposed new challenges for the optimisation of CM delivery and image acquisition strategies.ConclusionUnderstanding basic CM-imaging principles is essential for designing optimal injection protocols according to each specific clinical scenario, independently of scanner technology.Implications for practiceWith rapid advances in CT scanner technology including faster scan acquisitions, the risk of poor opacification of coronary vasculature increases significantly. Therefore, awareness of CM delivery protocols is paramount to consistently provide optimal image quality at a low radiation dose. |
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Keywords: | Coronary CT angiography Patient factors Radiation dose Contrast media |
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