What is coronary CT angiography?
Coronary CT angiography (CT Coronary Angiography) is a non-invasive imaging method that, through extremely high-resolution images obtained with specialized processing during a CT scan, allows for the detailed visualization of the coronary artery network. Using the technology of coronary CT angiography, the method provides high-resolution images of the interior of the heart’s arteries, thus enabling the assessment of the presence, nature (soft or calcified atherosclerotic plaques), and extent (plaque burden) of atherosclerotic plaques within the walls of the coronary vessels. In this way, the presence or absence of significant stenoses within the lumen of the heart’s arteries can be evaluated with great accuracy.
A characteristic image from coronary CT angiography shows a long atherosclerotic plaque in the left anterior descending artery (red arrow) with an associated moderate stenosis of up to 70%.
What is the difference between coronary CT angiography and diagnostic coronary angiography?
The main difference between coronary CT angiography and traditional diagnostic coronary angiography is that CT angiography is a non-invasive diagnostic method. In contrast to diagnostic coronary angiography, which requires the insertion of a catheter through an artery (usually in the arm or leg), coronary CT angiography is performed without direct intervention into the vascular system. Instead, a contrast agent is administered intravenously to highlight the vessels and allow image acquisition, through which the heart’s arteries are visualized in detail.
What preparation is required before the examination?
Before undergoing coronary CT angiography, it is important to follow specific instructions to ensure proper preparation and optimal execution of the test. Adequate control of heart rate to approximately 55–60 beats per minute is usually required to achieve better image quality and resolution.
This is accomplished with the systematic administration of beta-blockers, either orally for 2–3 days before the examination or intravenously on the day of the scan.
On the day of the scan, it is recommended to avoid beverages or substances containing caffeine and any physical exertion to prevent tachycardia.
Water intake is permitted, but it is advised to avoid food intake up to 4 hours before the examination.
How is coronary CT angiography performed?
Coronary CT angiography is performed on a specialized CT scanner (typically 128 or 256 slices), using a specific image acquisition protocol that allows for accurate imaging of the heart’s vessels and structures at a specific moment during the diastolic phase of the cardiac cycle (ECG-gated).
Initially, an intravenous catheter is placed in the upper limb (left or right arm), through which a contrast agent is administered. This contrast agent allows for visualization of the lumen of the coronary vessels and identification of any possible arterial stenoses.
During the procedure, the patient enters the CT scanner’s gantry, where the necessary images of the coronary arteries are acquired. During the scan, the patient receives additional breathing instructions from the technical staff (when to inhale, exhale, or hold their breath). This process is essential because the heart is a moving organ (it contracts and relaxes), and respiratory motion during image acquisition may cause artifacts that can affect image quality.
How long does coronary CT angiography take?
The duration of coronary CT angiography is typically very short, as image acquisition is completed within approximately 10–15 minutes. However, the total time spent at the medical facility may be slightly longer due to preparation and post-scan observation.
Are there any side effects or complications?
Coronary CT angiography is generally safe, with extremely rare and minimal side effects. Some patients may experience a temporary sensation of warmth or burning in the chest due to the injection of the contrast agent, which usually subsides within a few seconds.
Very rarely, allergic reactions to the contrast agent may occur, though serious complications are extremely uncommon. In cases where there is a history of allergic reaction to contrast media, the patient receives special premedication with steroids and antihistamines before the examination in order to prevent any allergic response after intravenous administration of the contrast agent.
Where is coronary CT angiography performed?
Coronary CT angiography is performed in specialized medical imaging centers or hospitals with CT scanning equipment and trained personnel.
The procedure is carried out in diagnostic imaging units that possess the required technology and expertise to perform the examination.
What is the cost of coronary CT angiography?
The cost of coronary CT angiography is not fixed and may vary depending on the hospital or diagnostic center where the scan is performed.
