1 / 44

CT Angiography: Patient Preparation, Acquisition, Contrast Medium, and Postprocessing Techniques

This article discusses the requirements for performing CT angiography, including patient preparation, acquisition parameters, contrast medium administration, and postprocessing techniques. It also provides information on contrast reactions and suitable gauge and canula selection.

jwillis
Download Presentation

CT Angiography: Patient Preparation, Acquisition, Contrast Medium, and Postprocessing Techniques

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. CTANGIOGRAPHY Dr. DevadasAcharya Prof. and H.O.D Department of Radio-Diagnosis Yenepoya Medical College YENEPOYAUNIVERSITY www.yenepoya.edu.in

  2. CT IMAGE OF THE BLOOD VESSEL OPACIFIED BY CONTRAST

  3. REQUIREMENTS FOR CTA • PATIENT PREPARATION • ACQUSITION PARAMETERS • CONTRAST MEDIUM ADMINISTRATION • POSTPROCESSING TECHNIQUES

  4. Patient Preparation

  5. INFORMED CONSENT

  6. PATIENT PREPARATION • Blood Urea 15-40 mg/dl • CREAT.- 0.6 –1.2 mg/dl • IODINE ALLERGY • Pregnancy? • eGFR >45 ml/min/1.73 m2 (Ideally >60) • NPO – 4-5 Hours

  7. High Risk Patients • Hypersensitivity towards iodine • Diabetes Mellitus • Asthma • Dehydration • Chronic/Acute renal disease

  8. GAUGE SUITABLE FOR CTA CANULA SELECTION • 22G • Paediatric • Peripheral Smaller veins • Slow Flow rate <3ml/sec • 18G • CT Angiography • High Flow rate 4-5ml/sec • ` • 20G • Routine CECT/Angio • Flow rate 3-4ml/sec

  9. TRI-IODINATED CONTRAST MEDIA

  10. 300 vs. 370 Iodine • 300mg/ml • Routine: • Cerebral Angio • Peripheral Angio • Pulmonary Angio • 370mg/ml • Selective Visceral Angio • Coronary Angio • Paediatric Angiocardiography

  11. How to Calculate Total Volume of Contrast Ideally volume of CM Adapted to concentration and Patient’s weight 1.7–2.0 ml/kg of 300 mgI/ml CM OR 1.4–1.6 ml/kg of 370 mgI/ml C

  12. CreatinineGuidlines • If the creatinine is ≤ 1.5 and the GFR is >60mL/min/1.73m2 – go ahead and administer contrast. • If the creatinine is >1.5 in a diabetic, >2.0 in a non-diabetic, or GFR is <30 mL/min/1.73m2, radiologist must discuss with the clinician.

  13. Visipaque It is the only iso-osmolar contrast agent, with an osmolality of 290 mOsm/kg H2O: The same as blood Used in Creatinine level upto 2.4 mg/dl

  14. ACQUSITION PARAMETERS

  15. PARAMETERS • Usually routine CT precedes a CTA exam • The routine exam is used as a reference scan helping to determine the scanning range in CTA.

  16. SLICE THICKNESS SPATIAL RESOLUTION SLICE THICKNESS

  17. CEREBRAL CTA ABDOMINAL CTA THORACIC CTA 1MM (LOWER mA) 3MM 3MM SLICE THICKNESS

  18. PITCH SPATIAL RESOLUTION SPIRAL PITCH 0.984 : 1

  19. kVp, mA, TIME • SIMILAR TO NON- CTA EXAM OF THE SAME BODY PART RECONSTRUCTION INTERVAL 0.625

  20. CONTRAST ADMINISTRATION

  21. POWER INJECTOR POWER INJECTORS

  22. POWER INJECTOR PARAMETERS VOLUME OF CONTRAST-ml RATE ml/sec TIME OF INJECTION – sec SCAN DELAY TIME - sec

  23. Pushes contrast in tubing and peripheral veins into central veins (20 – 30 cc) Reduced streak artifacts from veins and right heart SALINE CHASER Dual Injector

  24. Scan Timing

  25. Timing Bolus • Select target location from scout topogram • Inject small test-bolus; 15 – 20 mL contrast • Acquire low-dose scan at specified location • ROI in target structure • Measure time-attenuation curve • Contrast material arrival time in aortic root Scan Timing

  26. Bolus Triggering • Select trigger location • Acquire reference image • •Place ROI in vascular structure of interest • Inject contrast bolus • Monitor attenuation in ROI • Start scan when desired threshold reached Scan Timing

  27. Post Processing

  28. CTA - MPR

  29. CTA – Maximum Intensity Projection (MIP)

  30. CTA – Shaded Surface Display

  31. CTA – Volume Rendering

  32. CT Renal Angio

  33. CT Renal Angio

  34. CT Peripheral Angio

  35. CT Peripheral Angio

  36. CT Aortography

  37. CT Aortography

  38. CT Cerebral Angio

  39. ContrastReactions

  40. Thank You…

More Related