Dual Source CT unveils several high-grade stenoses of coronary arteries
SOMATOM Definition Dual Energy Scanning
Dr. Evgeny Egin
Department of Cardio Center Volgograd, Russia | 2009-03-20
A 77-year-old male patient presented with chest pain.at the Radiology department of the Cardio Center Volgograd, Russia in preparation for aortic femoral bypass surgery
The patient had a known history of several atherosclerotic arteries without hemodynamic relevant stenoses and atrial fibrillation.
The patient also suffered from chronic iron-deficiency, cerebral atherosclerosis with temperate Parkinson-Syndrome and intervertebral osteochondrosis with neurovascular disorders.
Prior to the contrast enhanced scan, a calcium scoring native cardiac scan was performed. Almost every segment showed coronary artery calcifications.
The coronary CTA was performed with an arrhythmic heart rate of 65 – 181 bpm, on average 94 bpm.
Aorta and pulmonary artery trunk and branches were not dilated.
The scan revealed a right dominant heart, wide left main coronary artery (LM), left circumflex artery (CX) and its marginal branch as well as the right ventricular branch, all without hemodynamic relevant stenoses.
A high-grade stenosis was detected in first diagonal branch (D1), approximately 8 mm from the ostium.
Significant calcified plaques in the proximal part of the right coronary artery (RCA) and the left coronary artery descending (LAD) causing high-grade stenoses with hemodynamic relevance were observed. Another high-grade stenosis was found in D1.
With the high temporal resolution of the Dual Source CT, it was possible to perform a reliable and quick diagnosis even with this extreme arrhythmic heart rate.
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