1. CT PULMONARY ANGIOGRAM Mr. M. Kartheeswaran Radiographer SRMC Chennai

2. INTRODUCTION CTPA was introduced in the 1990s as an alternative to ventilation/perfusion scanning, which relies on radionuclide imaging of the blood vessels of the lung. It is regarded as a highly sensitive and specific test for pulmonary embolism.

3. ANGIOGRAPHY Angiography is the visualization of blood vessel by injecting contrast media using invasive or non invasive technique.

4. ANATOMY The pulmonary arteries carry blood from the heart to the lungs. They are the only arteries that carry deoxygenated blood.

6. It is short and wide approximately 5 cm (2 inches) in length and 3 cm (1.2 inches) in diameter.

9. Aortic dissection

10. Aortic overloading

11. Left ventricular stress

13. Severe diabetes

14. Allergic to contrast reactions

16. Renal parameters are to be checked.

17. Nil oral preparation for 4-6 hours

18. Informed consent is to be got from patient

19. All metal objects are to be removed from the region of interest

20. Patient is changed into hospital’s cotton apron.

21. Enquire about allergic history

23. Rate of injection being 4-5 ml /sec

31. SCANNING PROCEDURE The caudal-cranial directionis used because most emboli are located in the lower lobes and,if the patient breathes during image acquisition, there is more coverage of the lower lobes compared with the upper lobes.

32. POST PROCESSING Volume rendering technique (VR) Maximum Intensity Projection (MIP)

33. Multi planar reconstruction (MPR)

40. MAIN AORTIC PULMONARY COLLATERAL ARTERIES

42. Non-invasive nature

43. Almost all radiology departments have CT scan

44. Less complication than conventional (elevated pulmonary arterypressures)

45. Lesser volume of contrast needed

46. Simple post procedure care

48. THANK YOU…