Ct pulmonary angiogram (ctpa)

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Ct pulmonary angiogram (ctpa)

  1. 1. CT Pulmonary angiogram (CTPA) 1
  2. 2. At a glance … Medical diagnostic test that employs computed tomography to obtain an image of the pulmonary arteries.  CT offers a method of direct visualization of the pulmonary vessels and lung parenchyma (structure in the lungs that permits gas exchange) using diagnostic x-ray images.  Main use is to diagnose pulmonary embolism(PE).  Uses a special dye (contrast material) and x-rays to see how blood flows through the lungs.  2
  3. 3. Why the Test is Performed?  The test is used to detect blood clots (pulmonary embolism)  May also be used to help your doctor diagnose: • AV malformations of the lung • Congenital (present from birth) narrowing of the pulmonary vessels • Pulmonary artery aneurysms • Pulmonary hypertension - high blood pressure in the arteries of the lungs 3
  4. 4. Pulmonary embolism Blockage of the pulmonary artery by foreign matter or by a blood clot 4
  5. 5. Arteriovenous malformation of the lung Arteriovenous malformation or AVM is an abnormal connection between arteries and veins, bypassing the capillary system 5
  6. 6. Pulmonary artery aneurysm An excessive localized swelling of the wall of pulmonary artery. 6
  7. 7. 7 How to Prepare for the Test?  You should not eat or drink anything for 6 - 8 hours before the test.  Health care provider need to be informed : • If the patient is pregnant. • If the patient ever had any allergic reactions to x-ray contrast material or iodine substances. • If the patient is allergic to any medications. • Which medications patient is taking . • If the patient ever had any bleeding problems.
  8. 8. How the Test is Performed ?  Performed in the radiology department scanning room  Patient lying flat (supine) on a CT table  A timed intravenous injection of contrast media allows for evaluation for pulmonary emboli.  CT scanner gantry (donut) passes over and around the patient to perform the scan. The gantry travels over the patient from the neck to the abdomen to create the scan. 8
  9. 9. How the Test is Performed ?(cont..)  Timing is essential and the radiographer will use instructions to indicate when to breathe in, breath out or hold breath.  Intravenous contrast is used to highlight the pulmonary vessels, and to determine the presence of a clot in the lung. If the patient lies very still, and the chest is stationary (breath hold) this optimizes the quality of the scan. 9
  10. 10. Gantry(donut) 10
  11. 11. Example of a CTPA  demonstrating a saddle embolus. The white area above the center is the pulmonary artery, opacified by radio contrast.  Inside it, the grey matter is blood clot.  The black areas on either side are the lungs, with around it the chest wall. 11
  12. 12. Risks  Allergic reaction to the contrast dye.  Damage to the blood vessel as the needle and catheter are inserted.  Blood clot traveling to the lungs, causing an embolism  Excessive bleeding or a blood clot where the catheter is inserted, which can reduce blood flow to the leg.  Heart attack or stroke.  Hematoma (a collection of blood at the site of the needle puncture).  Injury to the nerves at the puncture site  Kidney damage from the dye. 12
  13. 13. Advantages     Sensitivity Specificity Lesser volume of contrast needed Can be done in out patient basis 13
  14. 14. References  http://www.nlm.nih.gov/medlineplus/ency/article/003813.htm  http://healthengine.com.au/info/CT_Pulmonary_Angiogram  http://en.wikipedia.org/wiki/CT_pulmonary_angiogram 14
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