A systematic approach for analysis, interpretation, and reporting of coronary CTA studies

Abstract

Over the past years, the number of coronary computed tomography angiography (CTA) studies performed worldwide has been steadily increasing. Performing a coronary CTA study with appropriate protocols tailored to the individual patient and clinical question is mandatory to obtain an image quality that is diagnostic for the study purpose. This process can be considered the primary mainstay of each coronary CTA study. The secondary mainstay is represented by the correct analysis and interpretation of the acquired data, as well as reporting of the pertinent imaging findings to the referring physician. The latter process requires knowledge of the advantages and disadvantages of various post-processing methods. In addition, a standardized approach can be helpful to avoid false-positive and false-negative findings regarding the presence or absence of coronary artery disease. By implementing various radiation dose reduction techniques, care needs to be taken to keep the radiation dose of coronary CTA as low as reasonably achievable while maintaining the diagnostic capacity of the examination. This review describes a practical approach to the analysis and interpretation of coronary CTA data, including the standardized reporting of the relevant imaging findings to the referring physicians.

Concordance between preoperative computed tomography angiographic mapping and intraoperative perforator selection for deep inferior epigastric artery perforator flap breast reconstructions

“…This is due to a highly reliable outcome with the loss of one flap out of 49 (success rate of 98.0%) in the last four years. However, 16.7% of our cases (8 out of 48) did require an early revision. The indications were, for example, a hematoma, a second look at anastomoses because of venous congestion, fat necrosis or partial flap loss.…”

“…The protocol for postprocessing of the CT angiography consisted of axial and coronal 16/10 mm maximumintensity projections (MIP) as this allowed the arterial perforator tree to be rapidly reconstructed without the need for a complicated modification of multiple parameters. Thus the voxels of highest attenuation within a volume in the direction of view were displayed to provide an angiographic-like image (16).…”

Cinematic rendering – an alternative to volume rendering for 3D computed tomography imaging

“…Useful clinical applications of the VR technique for visualizing complex anatomy and pathology have been described in many radiological fields and include otorhinolaryngiology [9], neurosurgery and cranio-facial surgery [10], female imaging [1], vascular anomalies and variants [11, 12], and coronary artery anatomy and anomalies [13–15]. …”

Cardiac multidetector computed tomography in infective endocarditis: a pictorial essay

“…MSCT acquisition protocols to assess IE are performed in two different phases: the first acquisition, under ECG gating, covers the cardiac structures during first pass iodine injection The parameters used for this acquisition are similar to those used for coronary assessment and have been described in detail elsewhere [ 9 – 11 ]. Sixty-four-slice technology is a minimum requirement for assessing valvular and peri-valvular involvement and the coronary anatomy.…”