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Computed Tomography Angiography for Interventions and Surgery

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PanVascular Medicine

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Abstract

Computed tomography (CT) angiography is an indispensable technique for the evaluation of vascular disease. Technologic advances have made helical multidetector CT a standard modality for preoperative and postoperative imaging of the vascular system. In this discussion, we review basic concepts in CT scanning and scanner design as well as principles of CT angiography (CTA). We apply these principles to the selection of appropriate prescan and postscan parameters and review postprocessing techniques such as multiplanar reformatting and three-dimensional image reconstruction. We explain common artifacts associated with CT imaging. We then discuss clinical applications of CTA for planning endovascular interventions and performing postoperative surveillance. Finally, the risks of CTA such as radiation exposure and contrast nephropathy are reviewed.

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Abbreviations

Angiography:

Imaging technique using contrast material to depict the lumen of blood vessels.

Averaging artifact:

Artifact that occurs when an object is only partially within the imaged voxel, which can result in its blurring or omission from the final image.

Beam-hardening artifact:

Artifact that appears as streaks adjacent to areas of high density such as bone, metal and metallic stents, and contrast.

Bolus tracking:

Technology used to time image acquisition relative to time of contrast administration, thereby obtaining maximal vessel opacification.

Maximum intensity projection:

A method of 3-D reconstruction which displays differences in CT numbers between objects.

Multiplanar reformatting:

The reformatting of CT data into coronal or sagittal planes.

Multiple-object shaded surface display:

A method of 3-D reconstruction which assigns different colors to objects with different CT numbers.

Shaded surface display:

A method of 3-D reconstruction which renders the exterior of the vessel opaque, allowing visualization of vessel morphology.

Windowing:

A postscan setting which defines window level and window width to provide distinction between imaged structures.

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Authors and Affiliations

  1. Divisions of Cardiothoracic and Vascular Surgery, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3306, Los Angeles, CA, 90048, USA

    Stephen D. Waterford & Mihaela Te Winkel

  2. Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA

    Ali Khoynezhad

Authors
  1. Stephen D. Waterford
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  2. Mihaela Te Winkel
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  3. Ali Khoynezhad
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Corresponding author

Correspondence to Stephen D. Waterford .

Editor information

Editors and Affiliations

  1. Division of Cardiovascular Disease Department of Internal Medicine, Health Care Center Bitterfeld, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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© 2015 Springer-Verlag Berlin Heidelberg

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Waterford, S.D., Te Winkel, M., Khoynezhad, A. (2015). Computed Tomography Angiography for Interventions and Surgery. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_119

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  • DOI: https://doi.org/10.1007/978-3-642-37078-6_119

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-37077-9

  • Online ISBN: 978-3-642-37078-6

  • eBook Packages: MedicineReference Module Medicine

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