Step & Shoot (or AXIAL) scans are done when the BMI is less than 32 and/or heart rate is below 70

History:Evaluate coronary arteries or anomalies
Surview:Dual: Sternal notch to mid-kidneys
Contrast:Omnipaque 350 -6mL/sec for 75mL, then 5mL/sec for 40mL 50/50 mix saline/contrast, then 5mL/sec
for 50mL saline flush

 

Gated:Prospective(Axial)- 78% tagging
Tracker:1 cm below carina
ROI :Descending Aorta
HU :140

 

BREATHING INSTRUCTIONS:Practicing and coaching the breath hold is also extremely important and should be performed on
inspiration.

 

Note: REMINDERS FOR ALL GATED STUDIES:

  • Notify the Chest Radiologist before any cardiac study.
  • The best studies are acquired with a heart rate of 65-70 bpm. If the patient's heart rate is above the recommended rate, they should be given beta blockers before their study.
  • The Radiologist will give Betablockers for out patients.
  • Nitroglycerine 0.4-0.8 mg/sl tab should be given if it is not contraindicated (NTG will dilate the coronary
    vessels for a better scan)

 

Ca Score:Must be done at 120 kVp, mAs can not exceed 160.
DO NOT CHANGE kVp FOR CALCIUM SCORE
Use 100 kVp if BMI is <30
Adjust mAs to patients size
CTA:Scan superior to inferior for both Ca Score and CTA. Start at the level of the main pulmonary
bifurcation to bottom the of heart. Scan should be centered over the heart. CARDIAC DOSE RIGHT,
"Handle Irregularities on line", and Phase Tolerance should be on. Set phase tolerance to 5. These
parameters are found under the heart icon.
It is important to choose an appropriate mAs according to the patient's size.

 

Parameter Type :
CA SCORECTA
Thick/Incr.
2.5 @ 25.9 @ .45
Kvp
120120
mAs
80-160min. 180
Resolution
Std.Detailed
Collimation
32 x 0.625128x0.625
Pitch
N/AN/A
Rotation Time
0.330.27
Scan FOV
250250
Filter
CBXCB
HUN/A140
iDose4 Level
iD-3iD-3
Scan Delay
N/A5
Tagging
75%78%

 

Thin Section Recons..9 @ .45with EDGE CORRECTION
***PHASE TOLERANCE SHOULD BE SET @ 5

 

Post Processing73% and 83% with EDGE CORRECTION

 

ArchivingCalcium Score
CTA
Recon Phases


Courtesy of the University of Maryland