Abnormalities in LAD but not in plaque

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Clinical history

This 66-year-old female presented at PRC Shenton House wtih untreated hypercholesterolemia and chest pain. Invasive angiography performed four years earlier showed minor luminal irregularity in the left anterior descending (LAD) artery. Coronary CTA was requested to assess whether there was any progression of disease.
The technologist successfully performed a coronary CT using axial prospective gating (Step & Shoot Cardiac) on the Ingenuity CT system.

Image scan parameters

  • 55 ± 4 bpm heart rate

  • 80 kVp

  • 5.4 mGy CTDIvol

  • 62.4 mGy x cm DLP

  • 200 mAs

  • 0.87 mSv (k=0.014*) effective dose

* AAPM Technical Report 96


The images acquired on the Ingenuity CT showed that the right coronary artery (RCA) was normal (Figure 1a). However, a non-calcified plaque was observed in the LAD artery (Figure 1b), showing a minor luminal irregularity causing <25% diameter stenosis (grey arrow).

Clinical significance

The overall image quality was excellent with no motion or step artifact present. Contrast enhancement in the aortic root was 700 HU.
* Results from case studies are not predictive of results in other cases. Results in other cases may vary.

source : www. netforum. philipshealthcare.com

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