Dr.S Sivasubramanian MD,DNB,FRCR(UK).,

Applications of 64 slice CT

Diagnostic Imaging is revolutionized by the arrival of computers and software.

Newer technology is still developing due the advancements in software in medical imaging.

Applications of 64 slice CT

Has created an Imaging Renaissance

What is Multislice CT?

Also known as – MDCT…

ADVANTAGES Reduced scan time( single

breathhold imaging possible).

Excellent resolution

Isotropic resolution in any direction

Cardiac Imaging

Peripheral Vascular

CNS Applications

Body Imaging with Isotropic resolution

Musculoskeletal Miscellaneous

Cardiac Imaging

Calcium Scoring

Cardiovascular Coronary CTA

Function

4D Examination

What does Cardiac CT do ?

Calcium scoring Viewing the four major vessels Vessel analysis Stenosis Quantification Plaque differentiation Stent imaging Function Assessment

Who Should get Cardiac CT Done ?

Patient is Asymptomatic : Family history of coronary artery disease Persistent high triglyceride levels and other high risk factors

such as smoking, diabetes, etc. ECG abnormalities on a routine health check-up Equivocal (plus/minus) abnormalities on a routine stress test, insurance or as part of a routine health check-up Moderate to severe hypertension Prior to non-coronary surgery in the adult population, etc Pre-ASD repair

Pre-valvular repair Pre-tumor surgery

Who Should get Cardiac CT Done ?

The Patient is Symptomatic :

Atypical chest pain (right side, shoulder tip, etc.)

?Coronary ?Aorta ? Pulmonary.

Anomalous coronary arteries, ectasia or aneurysms

Other Indications:

Post-bypass

Post-stent

For stents larger than 3mm in size, cardiac CT is an excellent tool for assessing in-stent lumen. For stents smaller than 2.5mm, the results are still equivocal.

Tumors Cardiac CT is a good tool for assessing cardiac neoplasms

Calcium score

Plaque burden Probability of significant CAD

0 No identifiable plaque Very low, generally<5%

1-10 Minimal identifiable plaque Very unlikely <10%

11-100 Definite,mild atherosclerotic plaque burden

Mild to minimal coronary stenoses likely

101-400 Definite, moderate atherosclerotic burden

Non-obstructiveCAD highly possible, although obstructive disease possible

>400 Extensive atherosclerotic burden

High likelihood (>90%) of atleast one significant coronary stenosis

Post-processing

Sharp delineation of entire coronary artery tree with isotropic resolution and 0.33 s rotation time

MIP VRT

Sharp delineation of entire coronary artery tree with 0.33 mm isotropic resolution and 0.33 s rotation time

Advantages of 64-slice CT angiography as compared to invasive angiography

Better depiction of coronary anomalies

• Non-invasive

• More cost-effective

• Clear visualization of calcium deposits and plaque morphology

• Better delineation of stenoses at the origin of the right and left coronary artery

• True 3D imaging

• “One-stop shop” analysis—coronary arteries, valves, ventricular analysis, myocardial mass, plaque morphology, lung parenchyma

Radiological Society of NA News - August 2005

Disadvantages of MDCT ( very few).

No direct assessment of flow through the vesselsMassive calcifications and stents cause beam hardening artifacts, causing false-positives

Need for β-blocking medication when heart rates are elevatedNo interventions are possible during the examination

Radiological Society of NA News - August 2005

Vascular

Pulmonary

Abdominal

Aorta

PERIPHERAL

CNS Applications

CTA

Non Enhanced CT

CT DSA

Subtraction of data

Perfusion CT

For Early Stroke Imaging

Musculoskeletal :

Very good depiction of Bone Implants and prosthesis

Isotropic resolution,Virtual scopy

Virtual Endoscopy :

Miscellaneous

CT Urogram

CT- Bone Mineral Densitometry

Dental CT

Advanced Imaging

Better and faster Diagnosis.

Better and Early Treatment

Better Health

Thank you