Advances in cross-sectional imaging – CT, MRI and Ultrasound – have provided complementary tools for the non-invasive diagnosis of vascular disease. CT angiography or CTA provides accurate three-dimensional images of virtually any artery in the body. It is a powerful tool for the diagnosis of peripheral vascular disease, occlusive disease of the renal and mesenteric arteries, and aneurysms and occlusive disease of the thoracic and abdominal aorta. CT Angiography (CTA) has become the new “Gold Standard”.
This test is done to look specifically at the aorta. CT images are obtained from the aortic arch through the symphysis. No oral contrast is given. IV contrast is injected through an 18G IV at a rapid rate to get an optimum scan. Total test time is approximately 15 minutes. The test is usually performed to evaluate for arterial blockage, aneurysm, or dissection.
This exam is done to see the vessels that run from the neck up through the head. CT images are obtained from the aortic arch up through the head. I.V. contrast is administered to the patient to highlight the vessels. Patients are instructed to remove all metal from the head area including dentures. Total test time is approximately 15 minutes.
This study evaluates the aorta and its branches as it flows down through the body. CT images are obtained from mid-chest down to the feet. I.V. contrast is administered to the patient to highlight the vessels. The patient is instructed to lie very still and not move their legs during the scan. Total test time is approximately 20 minutes. Patients should bring previous films or related exams to their appointment. This information is very important and will expedite the report of the diagnosis back to the referring physician.
CT Angiography of the Coronary Arteries is a noninvasive imaging study that helps see fat and calcium deposits that have accumulated in the coronary arteries. These deposits, called plaques, can lead to blockages which can cause chest pain, shortness of breath, and/or heart attacks. If the patient has high cholesterol levels, high blood pressure, a family history of heart disease, diabetes, and/or smoke, he or she may be at risk for developing these plaques.
To prepare for the CTA study, the patient should not eat for 4 hours prior to their scheduled appointment and should not drink or eat caffeinated products for 12 hours prior to their appointment. The patient should not exercise on the day of the exam.
Patients should discuss with their primary physician or cardiologist whether this study would be helpful to assess their cardiac health.
The most common reasons to order a CTA of the Coronary Arteries are to:
Pictures are taken of the heart and coronary arteries using a special type of x-ray machine called a 64-slice multi-detector CT scanner. These pictures are obtained while contrast dye is given intravenously. The patient lies on an open table within a large donut-like structure that takes the pictures. The CTA scan is pain-free and takes 10 minutes.
CTA is the only noninvasive way to directly see plaque in the coronary arteries, and provides actual pictures of your arteries to help to accurately and painlessly assess your cardiac health.
Coronary catheterization is a more invasive test requiring a catheter (small tube) to be threaded into the coronary arteries. Dye is injected and pictures are taken. Although cardiac catheterization is excellent at finding blockages, unlike coronary CTA, it cannot see plaque in the walls of the coronary arteries that are not yet causing narrowing. Early detection aids early treatment. If a patient has a large blockage seen with CTA, then cardiac catheterization may be required later to open the blockage.
Another test, called a stress test, can be performed in conjunction with coronary CTA to see how well the heart muscle is functioning.
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