Evaluation of Plaque in segments of the LAD and RCA

Clinical history Of Patient

This 66-year-old female presented at PRC Shenton House with a new onset of exertional dyspnea. A transesophageal echocardiogram (TEE) showed a partial filling defect suspicious for stenosis in the proximal LAD (Figure 2a), and coronary CTA was requested for confirmation. The technologist used the Ingenuity CT system to perform the exam.

Image scan parameters

58 bpm heart rate
100 kVp
17.1 mGy CTDIvol
186.7 mGy x cm DLP
300 mAs
2.6 mSv (k=0.014*) effective dose

* AAPM Technical Report 96

Diagnosis

A predominantly non-calcified plaque was seen in the proximal segment of the LAD causing 70-90% stenosis, correlating with the echo findings (Figure 2b, green arrow). Additionally, a mixed plaque was also seen in the mid-segment of the RCA, causing 25-50% stenosis, and in the distal segment with <25% stenosis (Figure 2c, green arrows). The LAD was subsequently stented.

Clinical significance

The overall image quality was good, with a contrast enhancement of 591 HU in the aortic root.
The iPatient tools enable the technologist to quickly optimize parameters for cardiac scanning, enabling increased diagnostic quality from 84% to 90% and thus providing consistent high-quality coronary CT exams as part of PRC Shenton House's diagnostic radiology services.
* Results from case studies are not predictive of results in other cases. Results in other cases may vary.

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