Coronary CTA at Very High Heart Rate with Very Good Image QualityThe Royal Hospital, Muscat, Oman

A 58 year old female patient, presented with recurrent chest pain not related to efforts. Patient does not have a known history of diabetes or hypertension. Patient was diagnosed to have hyperlipidemia, currently on Statins. The existing pain is burning in nature with radiating to the jaw. Patient underwent an echo cardiogram showing normal LV wall motion and normal ejection fraction of 59%. Performed myocardial perfusion scan, showing no perfusion defect to suggest ischemic changes. ECG appears to be normal sinus rhythm with no abnormalities. Patient is referred for coronary CTA for further evaluation.

SOMATOM Force CT Scanner with adaptive ECG modulation technique was use to perform the scan. The patient's heart rate was 82 BPM at the nurse's preparation room but it rises to 100 BPM while on the CT table. Despite the ECG irregularities the exam was preceded with ECG adaptive sequence protocol.

High quality images of the coronary arteries were obtained. It showed no coronary artery stenosis. Dual source CT scanner with Adaptive (ECG-Pulsing – ECG-Controlled) Cardiac Spiral CT ultrafast 0.25s rotation acquisition bring about the possibility of high and irregular heart rate cardiac imaging. The radiation dose is modulated during the complete spiral CT scan by using information from the patient’s ECG. Thus the technique is reducing the mean radiation as well as the artifact cause by the heart rate.

Performing a coronary CTA requires stable low heart rate for achieving good quality exam. The use of Beta-blockers in reducing the heart rate is still a frequently used practice. However, the current advances in acquisition technology have allowed this particular requirement to be overcome. This is very true with the new technologies in the SOMATOM Force CT Scanner. The dual source technique with fast gantry rotation scan reinforces both the temporal and spatial resolution to be maintained at a high quality level.

The outcomes by Siemens Healthineers customers described herein are based in results that were achieved in the customer’s unique setting. Since there is no ”typical” hospital and many variables exist (e.g. Hospital size, case mix, level of IT adoption), there can be no guarantee that other customers will achieve the same results.

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