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Ct pulmonary angiogram
CT pulmonary angiography provides a non-invasive alternative to traditional pulmonary angiography for evaluating pulmonary embolism. It involves injecting iodinated contrast intravenously and using CT imaging to visualize the pulmonary arteries. The test is useful for diagnosing conditions like pulmonary embolism and assessing the pulmonary arteries and their branches. It has advantages over traditional angiography such as being less invasive, using less contrast, and allowing for imaging of the entire pulmonary arterial tree.
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Ct pulmonary angiogram
- 1. CT PULMONARY ANGIOGRAMMr.M. KartheeswaranRadiographerSRMC Chennai
- 2. INTRODUCTIONCTPA was introducedin the 1990s as an alternative to ventilation/perfusion scanning, which relies on radionuclide imaging of the blood vessels of the lung. It is regarded as a highlysensitive and specific test for pulmonary embolism.
- 3. ANGIOGRAPHYAngiography is thevisualization of blood vessel by injecting contrast media using invasive or non invasive technique.
- 4. ANATOMYThe pulmonary arteriescarry blood from the heart to the lungs. They are the only arteries that carry deoxygenated blood.
- 5. ANATOMY Pulmonary arterybegins at the base of the right ventricle.
- 6. It isshort and wide approximately 5 cm (2 inches) in length and 3 cm (1.2 inches) in diameter.
- 7. It thenbranches into two pulmonary arteries (left and right), which deliver de-oxygenated blood to the corresponding lung.
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- 11. Left ventricularstress
- 12. Teratology of FallotCONTRAINDICATION Renal failure
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- 14. Allergic tocontrast reactions
- 15. Pregnant patientsPREPERATION Enquire about pregnancy from females.
- 16. Renal parametersare to be checked.
- 17. Nil oralpreparation for 4-6 hours
- 18. Informed consentis to be got from patient
- 19. All metalobjects are to be removed from the region of interest
- 20. Patient ischanged into hospital’s cotton apron.
- 21. Enquire aboutallergic history
- 22. A prominentvein in patients upper limb is catheterised with 18-20 guagevenflon.CONTRAST DOSAGE 1.2ml /kg (body weight) of non-ionic iodinated contrast medium is injected intravenously into the patient using a pressure injector.
- 23. Rate ofinjection being 4-5 ml /sec
- 24. Pressure 325ppmPATIENT POSITIONING Patient is positioned feet first with the help of laser localizers at the level of sternal notch with coronal beam at mid-axillary line
- 25. Proper immobilizationshould be donePATIENT POSITIONINGProper breath hold instructions should be given
- 26. Ensure thepatient connected IV lines, are long enough to allow full travel of the couch without being pulled or entangled while undergoing a CTPATIENT POSITIONING Test dose of about 2 – 5 ml of contrast is injected and patient is observed for any reaction associated
- 27. Patency shouldbe checked before starting the scanSCAN PARAMETERS
- 29. SMART PREP TECHNIQUEItis a software, that allows real-time monitoring of IVContrast enhancement in the area ofinterest.
- 31. SCANNING PROCEDUREThe caudal-cranialdirectionis used because most emboli are located in the lower lobes and,if the patient breathes during image acquisition, there is more coverage of the lower lobes compared with the upper lobes.
- 32. POST PROCESSINGVolume renderingtechnique (VR)Maximum Intensity Projection (MIP)
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- 40. MAIN AORTIC PULMONARYCOLLATERAL ARTERIES
- 41. ADVANTAGES AND DISADVANTAGESLess time consuming
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- 43. Almost allradiology departments have CT scan
- 44. Less complicationthan conventional (elevated pulmonary arterypressures)
- 45. Lesser volumeof contrast needed
- 46. Simple postprocedure care
- 47. Can bedone in out patient basisCONCLUSIONConventional pulmonary angiography has long been consideredthe gold standard in the diagnosis of Pulmonary pathologies and historically itis the technique against which all other modalities have beenmeasured. This position has now been seriously challenged byhelical CT Pulmonary Angiography and now it is set to replace it as the newgold standard.
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