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Type of investigation:
     64 Slice ECG-synchronized CT Angiography.

Contrast administration:
     Complex three-phase protocol that provides simultaneous and individual contrasting of aorta, pulmonary and coronary arteries.

     Evaluation of the pulmonary arteries, thoracic aorta and coronary arteries during a single examination. Cardiac morphology, myocardial perfusion defects, mediastinal structures and lung areas are examined additionally.

     Patients for whom is difficult to decide on the cause of acute thoracic pain after having undergone detailed anamnesis, physical examination, ECG, cardiac biomarkers and risk stratification for acute cardiac event (e.g. TIMI).

     Patients for whom it cannot be determine clinically/paraclinically the origin of acute chest pain and difference between acute aortic dissection (or other acute aortic syndrome), pulmonary thromboembolism and acute coronary syndrome (significant coronary stenosis) is needed to be made.

General information:
     ECG-synchronized CT Angiography is mostly used for the examination of patients with acute thoracic pains in order to exclude, during a single examination, pulmonary embolism, acute aortic and coronary syndromes. This strategy is called “triple rule-out”.
     After detailed anamnesis, physical examination, ECG, cardiac biomarkers and risk stratification for acute cardiac event (e.g. TIMI) 10% of patients with heart attack are not diagnosed.
     Triple rule-out protocol is designed to solve this dilemma and allows the clinical detection of significant pathology or assignment of patients to diagnostic algorithms.
     64 Slice ECG-synchronized CT Angiography combined with a complex three-phase protocol of contrast substance administration has high diagnostic and well established value in pulmonary thromboembolism and acute aortic syndrome (especially acute aortic dissection). The investigation allows the detection of significant coronary stenosis with a sensitivity and specificity between 86-100% and 92-98%, respectively. Multicenter studies have shown a decrease of irrelevant hospitalizations and effective exclusion of acute coronary syndrome. The examination is accurate and safe.
     Efficiency is also motivated by the decreased need to perform a series of additional investigations that exceed together the cost of a single, seemingly expensive investigation.
     Finally, CT Coronary Angiography has prognostic value in patients with acute chest pain and without imaging changes, with a very low risk for acute cardiac events in the future.

Imaging Doctor, 
Dr. Anatolie Cazacu


Figure 1 – Planar reconstruction of the right coronary artery (RCA). No CTA data for RCA stenosis lesions.
Figure 2 – Virtual reconstruction of the heart with coronary and main arteries. The image shows the presence of patent ductus arteriosus (PDA) – incidental imaging screening.
Figure 3 – MIP reconstruction of the pulmonary arteries. CTA data without pathological changes of pulmonary arteries, including pulmonary thromboembolism.
Figure 4 – Obliquely planar reconstruction of the thoracic aorta. CTA data for pathological changes are not clinically significant. The presence of PDA, incidentally detected.
The range of CTA data shows ECG-synchronized high quality images and complexity of parallel contrasting of cardiovascular structures.
Virtual reconstruction of the circulatory system.
Separate virtual reconstruction of the heart and coronary arteries, thoracic aorta and pulmonary arteries.

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Infoline and Appointments
84 00 00
bd. Negruzzi 4/2
realizat de DQ Team