Michael Ficorelli

 To describe clinical indications for C.T.A. examinations in the circulatory system. To understand and recognize anatomy and landmarks. To show the proper scan protocols and procedures.

 Indications  Heart Circulation  Contrast rate  General scanning protocols  Circle of Willis  Carotid artery  Thoracic aorta  Pulmonary  Abdominal  Renal  Lower Leg

 Angiography  Better than MRA no motion of flow phenomon  Less contrast than interventional  Done in less time not invasive  With MDCT fast scan less misregistration and short breath hold time  Good spatial resolution  CTA uses port processing  Maximum intensity projection  Multi-planner imaging  Volume rendering

 Post processing  Use overlapping reconstructed slices for mips  Good to subtract out bone and other anatomy  Image can be rotated in all planes sag, cor, ax  Can be turned into a negative image in in interventional

 Best to overlap data  Can reconstruct in any plane  Good views to measure aneurysms

 Uses all axial data to recon images  All the voxel information is used  Displays internal structures and vessels  On most work stations tech can put color to images

 Dissection  Aneurysms  Plaque  Stenosis  Morphology  Pre and Post surgical assessment  Arteriovenous malformation

 Pre contrast phase  Anatomical morphology  Determines the presence of ▪ Lession ▪ Cyst ▪ Calcification  Arterial phase  Determines ▪ Tissue morphology ▪ Pathology ▪ Tissue profusion  Venous phase  determines ▪ Filling defects ▪ Tissue profusion ▪ Vascular insufficiency

ANEURYSM PRE POST

 MIP  VRT  MPR CORONAL AND SAGITAL

BASILAR STENOSIS

PRE CONTRAST

FALSE LUMEN2- TRUE LUMEN3- THROMBUS

 Note that the portal vein drains blood into the liver, not from the liver. The blood entering the liver from the portal vein, after being cleaned by the liver, flows into the inferior vena cava via the hepatic veins. The inferior mesenteric vein usually does not directly connect to the hepatic portal vein; it drains into the splenic vein. inferior vena cavahepatic veins inferior mesenteric vein

VRT WITH BONEVRT WITHOUT BONE

RENAL ARTERIES ARE AT THE LEVEL OF L1-L2

AXIAL

MIP IMAGEVRT IMAGE

 Peripheral Vascular Disease:  Occlusive and Aneurismal Disease  Evaluate extent of disease  Plan future intervention  Extremity CTA Indications  Assess previous surgery  Trauma  Congenital changes