Pre-operative exclusion of coronary artery stenosis with less than 1mSv dose
Authors: Sebastian Leschka, MD *; Andreas Blaha **
*Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
**Business Unit CT, Siemens Healthcare, Forchheim, Germany | 2009-12-16
A 71-year-old male patient with a history of cerebral infarction caused by a high-grade stenosis of the left internal carotid artery and lysis therapy was now referred to the radiology department to rule out coronary artery disease.
In addition to the coronary CT-angiography examination (CTA) a non-enhanced calcium-scoring scan (CaSC) was performed.
The CTA was acquired with a fast pitch spiral technique (Flash Spiral Cardio) while a mean heart rate of 56 bpm was present.
In total, ten calcified lesions could be detected in the CaSc. Diffuse distribution of calcified deposits was observed in the right coronary artery (RCA), the left coronary artery (LAD) and the left circumflex coronary artery (CX). The total Agatston score was 130.
CTA unveiled a normal coronary artery anatomy, right dominant coronary supply type with regular sized lumen of the coronary arteries. RCA and LAD showed no hemodynamic relevant lesions. CX coronary artery unveiled a < 50% stenosis in its proximal segment. A deep myocardial bridging of the LAD could also be depicted.
In combination with the CaSc (0.35 mSv) and the CTA (0.8 mSv), an effective dose of 1.1 mSv was applied to the patient to detect coronary artery disease. The entire acquisition time of the CTA was 280 ms; calcium scoring was acquired in 120 ms.
The Flash spiral cardio method quickly and reliably combines low radiation dose values with the accurate display of the coronary arteries in all segments.
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