CT angiography refers to a computed tomography (CT) exam that is specially designed to evaluate arteries in the body. CT angiography includes renal CT angiography, coronary CT angiography, carotid CT angiography and other vascular CT angiography. CT angiography is a relatively new technique in the evaluation of coronary arteries and has undergone tremendous advances with the introduction of 64-slice CT. 64 slice CT refers to scanners that have 64 rows of detectors instead of just one row. This allows for higher quality images because more of the heart can be scanned with each rotation of the scanner. The scans can also be performed in a shorter amount of time, which is critical in the evaluation of the small and moving coronary arteries. At Advanced Imaging Newport Coast, we use 64-Slice computed tomography in all angiographic studies.
Prior to 64-slice computed tomography, CT angiography studies did not produce images with the same level of quality. The main problem is that unlike other parts of the body, the heart is in constant motion. The coronary arteries are very small, and this small size combined with the motion of the heart made it difficult to evaluate the coronary arteries. With new generation 64-slice computed tomography, images of the entire heart are rapidly created.
64-slice CT angiograms are less invasive than traditional catheter-based angiograms. A catheter based angiogram uses a catheter to inject dye into a large artery or vein, and the heart is then visualized by x-ray technology. Catheter angiograms provide better resolution than CT angiograms, though they are more invasive and prone to complications.
CT angiograms can be used to evaluate areas of individual coronary arteries where the accumulation of plaque has led to narrowing of the artery. CT angiography can evaluate narrowings due to calcified plaque, as well as soft plaques that do not have calcium and are frequently the cause of sudden heart attacks. The main drawback to CT angiography is difficulty in the evaluation of arteries when there is severe calcification. In these cases, fluoroscopic angiography (performed by a cardiologist) is required. This study is performed in a cath lab by a cardiologist, and provides the gold standard in evaluation of narrowing of the coronary arteries.
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