CT-SCANS AND MRI-SCANS OF ARTERIES
Diagnostics
Angio-CT Scan Aorta, Pelvic Arteries and Leg Arteries
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A CT-scan performed to visualize the major arteries in your body
What is an Angio-CT and how does it work ?
The Angio-Computed-Tomography scan uses intra-venous (I.V.) iodine based contrast media to detect the major vessels of your body. We regularly use it for the Aorta, the pelvic arteries and the leg arteries. As for any other CT scan, you will be lying down on the CT scanner table. A small I.V. catheter will be placed in one of your arm veins. This will be used to apply the contrast media.
The CT scanner uses X-rays to acquire several pictures from the inside of your body, which then will be processed to 2D and 3D images of the area of interest. It is mostly the inside of your vessels that will be visualized. The actual test takes about 15 minutes.
Pre-test preparations: you must be fasting (no food or drinks for at least 6 hours prior to the test) and you should communicate possible allergies to iodine. Further instructions especially regarding medication intake will be given by your doctor.
Why would you need Angio-CT?
You need an Angio-CT scan when your doctor suspects any sort of arterial vascular disease, maybe an aortic aneurysm, a narrowing of your pelvic arteries or of the arteries of your legs.
Pre-evaluation tests like Echo-doppler exams of your legs may be performed prior to the Angio-CT.
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During the Angio-CT
One rare side effect of the test is the allergic reaction to the iodine inside the contrast media. It is important to communicate any previous adverse reactions prior to starting the test.
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Aftercare
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Diabetic patients should drink plenty of water after the test to eliminate the contrast media.
Diagnostics
Angio-MRI/MRA
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Magnetic resonance angiography/MRA is a type of MRI that looks specifically at your blood vessels.
What is the MRA and how does it work
In this test, radio waves, a magnetic field, and a computer create a scan of your body to look for health problems.
Similar to a CT-scan test, you will lie flat inside the magnetic resonance imaging scanner. This is a large, tunnel-like tube. In some cases, a special dye, known as contrast, may be added to your bloodstream to make your blood vessels easier to see. When needed, the contrast is given with an intravenous (IV) needle.
Unlike the CT-scan technique, NO X-Rays are being used and the contrast media is NOT iodine based therefore allergic reactions to iodine cannot occur and there is no iodine interference in patients who have thyroid function problems.
Why would you need an MRA?
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If your healthcare provider believes that you may have a narrowing or blockage of blood vessels somewhere in your body, he or she may recommend an MRA magnetic resonance angiography.
Conditions that your healthcare provider can look for during this test include:
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An aneurysm or weakness in the wall of an artery, especially the Aorta
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Narrowing or blockage of the vessels in the arms or legs
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Renal artery stenosis, a narrowing of the blood vessels in the kidneys that can lead to high blood pressure and even renal failure
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During the MRA test
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You might experience some anxiety when placed inside the MRI/MRA scanner, which is a small, narrow space. If you think you might be claustrophobic, be sure to inform your healthcare provider of this in advance. You may be given a mild sedative to make being in the MRI/MRA scanner more bearable.
You will receive intravenous contrast media, you must be fasting for at least 6 hours prior to the test.
The MRI scanner typically makes a lot of noise, including loud humming noises, so don’t be alarmed.
You will remove any clothing, jewelry, or other metal objects, that may interfere with the scan and put on a gown. You must inform the physician about any implanted metal devices prior to the test. These may prohibit you to undergo the MRA exam (e.g. certain pacemakers).
You will need to lie still during the scanning process. Any movements can blur the images and cause the results to be less accurate.
The full scan may take an hour or longer. This will depend on the type and number of blood vessels that your healthcare provider wishes to examine.
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Aftercare
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None needed
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Diagnostics
Coronary Artery CT Scan
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Angio-CT scan specifically for the coronary arteries
What is a Cardiac/Coronary CT Scan?
This test uses a special computed tomography (CT) scan to show the amount of hardening of the artery wall (atherosclerosis) that has occurred in your heart and is used to ascertain your risk of a heart attack or stroke within the next 5-10 years.
Coronary arteries that supply the heart muscle can have fat and inflammation cells deposited in their inner layers. Over time these inflamed deposits accumulate calcium and may get large enough to cause significant blockages of the arteries.
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The injection of a contrast agent allows for non-invasive assessment of any significant narrowing of the heart arteries by detecting both hard calcific narrowings as well as softer, fatty deposits that may exist.
Similar to other Angio-CT scans, you must fast for at least 6 hours prior to the scan. In case you have allergies to contrast media, you must communicate it prior to the test.
Also, your doctor will inform you if you need to stop any medications prior to the Angio-CT.
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What is the difference to a coronary artery calcium (CAC) CT exam?
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This is nowadays often combined with the Coronary artery CT Scan.
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The result of the test is a calcium score or called agatston score, named after Arthur Agatston, M.D., who is the namesake of the Agatston calcium scoring risk assessment for heart attacks. It is calculated based on the amount of calcium plaque observed in the heart arteries on the CT scan.
A coronary artery calcium (CAC) CT exam determines the patient's risk of having a coronary event and if they need to go or stay on statins.
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The higher the score the more it correlates with the presence of atherosclerosis and your risk of heart disease.
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A score of zero means no calcium is seen in the heart arteries and it suggests a low chance of developing a heart attack in the near future.
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A score of 100 to 300 means moderate plaque deposits and a higher risk of a heart attack in the near future.
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A score greater than 300 is a sign of very high to severe disease and heart attack risk.
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Why would you need a coronary artery calcium (CAC) CT exam?
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When Coronary artery disease is suspected, and a contrast CT is not feasible.
The strategy of CAC monitoring is to start scanning men after age 40 and women after age 50, or earlier if there is strong family history of coronary disease. The scans will show any development of plaque.
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Why would you need a Coronary CT scan?
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When Coronary artery disease is suspected.
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During the Coronary CT scan
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The test uses a recording of the electrical pulses from your heart every time it beats using an electrocardiogram (ECG) to control the processing of the scan images. The procedure is straightforward, with electrode patches attached to your chest for the ECG wires. You will then be asked to lie down on a table and hold your breath while it and you move through the X-ray machine that takes images of your heart.
Once the radiographer has checked the scan was successful, you are free to leave the clinic. Your consultant will review the scan before deciding on what further treatment (if any) is needed. The amount of calcium seen can also be used to predict your future risk of heart attacks.
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Aftercare
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You may drink water after the test to enable better contrast media removal from your body.
Cardiac MRI (Magnetic Resonance Imaging)
Diagnostics
The Cardiac MRI uses Conventional MRI sequences adapted for cardiac imaging by using ECG gating and high temporal resolution protocols.
What is the Cardiac MRI and how does it work?
In this test, radio waves, a magnetic field, and a computer create a scan of your body to look for health problems.
Similar to a CT scan test, you will lie flat inside the magnetic resonance imaging scanner. This is a large, tunnel-like tube. In some cases, a special dye, known as contrast, may be added to your bloodstream to make your blood vessels easier to see. When needed, the contrast is given with an intravenous (IV) needle.
Unlike the CT scan technique, NO X-Rays are being used and the contrast media is NOT iodine based.
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Why would you need an MRI?
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If your healthcare provider believes that you may have a structural or functional heart problem, you may be prescribed a cardiac magnetic resonance test. Conditions that your healthcare provider can look for during this test include:
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During the MRI test
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You might experience some anxiety when placed inside the MRI scanner, which is a small, narrow space. If you think you might be claustrophobic, be sure to inform your healthcare provider of this in advance. You may be given a mild sedative to make being in the MRI scanner more bearable.
You may receive intravenous contrast media, in this case you must be fasting for at least 6 hours prior to the test.
The MRI scanner typically makes a lot of noise, including loud humming noises, so don’t be alarmed.
You will remove any clothing, jewelry, or other metal objects, that may interfere with the scan and put on a gown. You must inform the physician about any implanted metal devices prior to the test. These may prohibit you to undergo the MRI exam (e.g. certain pacemaker dices).
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You will need to lie still during the scanning process. Any movements can blur the images and cause the results to be less accurate.
The full scan may take an hour or longer. This will depend on the type and number of blood vessels that your healthcare provider wishes to examine.
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Aftercare
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None needed