Techniques and Pitfalls of Multi-Slice CT Coronary Angiography

Study Overview
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Brief Summary
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The goal of this study is to describe the techniques for coronary multi-slice CT angiography and to illustrate the spectrum of artifacts that can simulate coronary artery stenosis and lead to non-assessable segments using 128- and 160 multi-detector row CT scanners and discuss post-processing pitfalls with each. In addition, to review the normal anatomy and anatomic variants of the coronary arteries and discuss effective strategies for improving the diagnostic accuracy of coronary CT angiography.

Official Title
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Techniques and Pitfalls of Multi-Slice CT Coronary Angiography

Conditions
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Computed Tomography Angiography, Coronary Artery Disease

Intervention / Treatment
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* Radiation: Coronary computed tomography angiography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male and female patients of at least 18 years of age, with suspected symptomatic CAD. Exclusion Criteria: Un cooperative patients. Those who have allergy to iodinated contrast material or contrast-induced nephropathy, Elevated serum creatinine level (1.5 mg/dl) or creatinine clearance >60 ml/min. Atrial fibrillation. Aortic stenosis. Percutaneous coronary intervention within the past 6 months. Intolerance to beta-blockers. Body mass index > 40 Patients with Agatston calcium scores of >400

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Participants<br> | Radiation: Coronary computed tomography angiography<br>* All patients will be subjected to: Two CT scans (coronary calcium scoring and angiography) using 128 or 160-row scanners with a slice thickness of 0.5 mm (Revolution Evo 128, GE Health care, Chicago, Illinois, USA) or (Aquilion 160, Canon Medical Systems, Tochigi, Japan). Calcium scoring will be performed with the use of prospective electrocardiographic gating with 400-ms gantry rotation, 120-kV tube voltage, and 300-mA tube current. For CTA, retrospective electrocardiographic gating will be used, with heart rate adjusted gantry rotations of 350 ms to 500 ms to enable adaptive multisegmented reconstruction. Iopromide (Ultravist 370, Bayer AG, Berlin, Germany) is the intravenous contrast medium that will be used for CTA. Beta-blockers will be given if the resting heart rate is 70 beats/min.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of techniques | The number of possible techniques used to perform CT coronary angiography | 2 months | 
| Number of pitfalls | The number of pitfalls that could mimic coronary artery stenosis and lead to non-assessable segments | 3 months | 
| Number of possible strategies to overcome the pitfalls of the study |  | 3 months |