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Introduction
Refinements in computed
tomographic (CT) angiography of the
coronary vessels have enabled the
minimally invasive detection of
coronary artery stenoses, with high
sensitivity and specificity
To date, calcium score (CS) and CT
angiography (CTA) have been used
almost exclusively to screen patients
for risk of coronary artery disease
or risk of future cardiac events .
The development of
CT scan in the past
30 yearscome to
role in cardiac
imaging.
History of CT scan
1971: Hounsfield discovered and
menufactured first CT SCAN (EMI Mark 1-Head scan).
1974: whole body (ACTA)
1974:3rd generation CT scan(Artronix)
1977: 4th generation CT scan (AS&E scanner)
1979:Nobel prize to Hounsfield and Cormack.
1983:dynamic spatial reconstruction
1983:electron beam CT scanning(EBCT)
1987:CT with continously rotating tube
1989:Spiral CT scan
1991:dual slice spiral CT( elscint)
1991 : CT angiography
1995:CT real time reconstruction/CT
fluoroscopy
1998:Multislice CT(4-detector rows)
1999:Multislice cardiac imaging
2001/2:Multislice 8/16 detector rows
2004 : multislice 32/64 detector rows
Future: cone beam CT (>128 detector
rows
Temporal resolution
250ms
200ms
160ms
100ms
4
16
64
EBCT
3mm
Spatial resolution
(diameter coronary artery 24mm.)
2
1mm
0,75mm
0,6mm
0
EBCT
16
64
0,2mm
angio
Scan time
40
30
sec
20
10
5
4
EBCT
16
64 MDCT
Prospective
good result :
Radiation dose
CTA Coronary
6 15 mSv
CT Calcium Scoring ~0.6 mSv
Cardiac Catheterization 1 10 mSv
Nuclear scan
Tc-99m (rest only) 4 5 mSv
Tc-99m (rest+stress)
9 13 mSv
Tl-201 (rest+stress)
~34 mSv
Natural Background (Annual)3 mSv
11-100
101-400
> 400
recommendation
healthy diet,stop
smoking.
+tight control of
DM and hypertension,
consider of using statin.
+statin,aspirin
+exercise program,
folic acid, vit.E
+stress test,coronary
angiography
Contoh hasil
PDA =0
LAD=0
LCX=0
tn.HS,69th.
Riwayat AMI,
hiperlipidemi
Post CABG
Stenosis proximal
LAD
Tn.RW,60th.Riw.perokok,DM,Chol.
Keluhan: tidak ada, rajin jalan pagi .
Summary
THANK YOU
pmw,feb.2007