GATED CTA CHEST/ABDOMEN/PELVIS TAVR PROTOCOL(last updated 09/24/2019, last reviewed 02/10/2022)
(last updated 09/24/2019, last reviewed 02/10/2022)
INDICATION: Pre TAVR evaluation (generally ordered by CV surgery or cardiology).
To PACS:
To TeraRecon:0.63 mm axial source BestSystole (ensure correct phase - mitral valve CLOSED. This should be ~20-40%)
0.63 mm axial source BestDiastole (ensure correct phase - mitral valve OPEN. This should be ~70-75%)
0.63 mm axial source C/A/P angio
2 mm axial, sag, cor C/A/P angio (with soft tissue kernel)
5 mm axial and coronal chest lung kernel
3D candy cane rotating aorta C/A/P recon
0.63 mm axial retrospectively gated source chest images (multiphase 0-90%)
0.63 mm axial source C/A/P angio0.63 mm axial BestSystolie
0.63 mm axial BestDiastole
0.63 mm axial BestDiastole
| | GATED CTA CHEST | CTA CHEST/ABDOMEN/PELVIS |
|
POSITIONING/MODE
|
supine/helical |
supine/helical |
|
kV/mA/rot time
|
120 kV/auto mA/0.5 sec |
120 kV/auto mA/0.5 sec |
|
DETECTOR COLLIMATION
|
0.6mm x 64 |
0.6mm x 64 |
|
SLICE THICKNESS
|
0.6mm |
0.6mm |
|
PITCH
|
0.2 |
1.0 |
|
TABLE FEED
|
0.6mm |
0.6mm |
|
KERNAL
|
B36f HeartView Medium ASA and lung |
B40f Medium |
|
SFOV
|
200mm |
200mm |
|
COVERAGE
|
Neck base to Cardiac apex |
Inferior aspect angle of mandible to below lesser trochanter/upper thigh |
|
ACQUISITION
|
craniocaudal |
craniocaudal |
|
ORAL CONTRAST
|
none |
none |
|
IV CONTRAST
|
60 mL Omnipaque 370 (<180 lbs) 80 mL Omnipaque 370 (>180 lbs) |
---- |
|
INJECTION RATE
|
4 mL/sec |
---- |
|
SCAN DELAY
|
6 sec |
following chest |
|
RESPIRATION
|
Inspiration |
Inspiration |
|
POSTPROCESSING
|
As above in "Series" |
As above in "Series", including 3D MIPS CAP |
IMAGING REQUIREMENTS FOR EDWARDS TAVR
CHEST/AORTIC CTA
- Coverage (at least) carina to 2cm below level of left ventricular apex
- Valvular structures must be clearly discernible for 3D reconstruction. Structural borders must be clearly defined and maintain aligment between slices.
- Scans with motion, banding, or step artifact cannot be processed.
- Contrast enhancment is required.
- Slice thickness 0.625mm or less is preferred. Slice thickness >1.25mm cannot be processed.
- Series should be separated and clearly labeled.
- 20 to 35% R-R interval is preferred
- Gating is required: ECG triggering or retrospective ECG gating is acceptable.
CTA FOR VASCULAR ACCESS (CAP):
- Coverage inferior aspect mandibular angle through femoral/superficial femoral artery bifurcation
- Contrast enhancment is required.
- Slice thickness 5mm or less is preferred. Slice thickness >5mm cannot be processed.