Cardiac CT: Pitfalls and Artifacts

44 Pages·2013·6.22 MB·English

Pitfalls to Avoid:
Cardiac CT
Shawn D. Teague, MD
Associate Professor of Clinical Radiology
Chief of Cardiothoracic Imaging
Indiana University School of Medicine
Disclosures
3DR Advisory Board Member
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Avoid vs Overcome
10 Pitfalls to Avoid
1. Inappropriate patients
2. Breathing artifact
3. Fast heart rates
4. Inappropriate R-wave triggers
5. Inappropriate phase for evaluation
10 Pitfalls to Avoid
6. Noisy images
7. Incorrect amount of contrast
8. False trigger of scan
9. Failure to utilize ECG editing
10.Dose reduction
Appropriateness guidelines
J Am Coll Radiol. 2006 Oct;3(10):751-71.
1. Appropriate patients
Without known CAD
Symptomatic, Asymptomatic, or new CHF
Pre-op for non-coronary cardiac surgery
Prior test results
After revascularization
Adult congenital heart disease
Cardiac structure and function
Pretest probability of CAD
Low < 10% Intermediate 10-90% High > 90%
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Non-acute symptomatic
ECG interpretable AND can exercise
Intermediate
ECG uninterpretable OR unable to exercise
Low and Intermediate
Acute symptomatic
Low and Intermediate
Not ECG or biomarker positive for acute MI
Normal ECG and cardiac biomarkers
ECG uninterpretable or Non-diagnostic
Equivocal cardiac biomarkers