Pulmonary CT Angiogram Basics
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- Опубликовано: 26 ноя 2016
- Textbooks I like for chest radiology-
Med students and all residents: Felson’s Principles of Chest Roentgenology
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Radiology residents: Thoracic Imaging: Pulmonary and Cardiovascular Radiology
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Thoracic radiology fellows: Muller’s Imaging of the Chest: Expert Radiology Series
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I like to search the data on RUclips more than reading the assigned text book , there is a lot of good learning resources here . Thanks a lot for this good presentation.
I'm a CT Scan technologist and this was very helpful too.
Thank you so much! All your videos are so helpful and informative.
Hi Rishi
Many thanks for your time and efforts!
Cheers!
Thank you. Excellent presentation
Thanks for sharing your knowledge.
Thank you for your efforts ♥️
Amazing tips at the end!
Thank your for this video. Very good!
Hi , I am a cardiothoracic surgeon and this video was of great help for me too
My doctor recommended pulmonary ct ....wud it be helpful to detect covid if present???
So helpful.
Thank U so much
Very good lecture.
Can you describe the path of the contrast. Where does it come in from and the order to where it goes from first to last please.
Very good information. Pls show neck and brain angio
Hey Rishi, Its really useful. Thanks. Can you please make a video on bronchial angiogram or a hemoptysis protocol also???
Thanks
Colon or large intestine ulcers can be seen in ct scan?
Loved the video. Did you ever release the second portion you talked about? (chronic PE + heart strain). if not, please do. Excellent videos.
Here is the video about right heart strain. I finally made it. Here is the link: ruclips.net/video/QHYOuudasF0/видео.html
What exactly does it mean when a radiologist states ”with regards to evaluation of pulmonary embolus, the study is diagnostic to the segmental pulmonary artery level”? I’m thinking that it’s in reference to the amount of contrast. Just not sure if delay was too short or too long. Can you please shed some light. Thank you!
The arteries are named by their level of branching. There's the main artery which branches to the right/left, then lobar, then segments, then subsegments. That means they could only clear the segmental arteries but not past that. It may be that the contrast was not enough but it can also be due to other artifacts like motion.
Good 👍✅
What is the name of software that you use in this video and how i find it?
It is called OsiriX, for Mac only. There is a free version available
Waooo Mashallah
Hi I have a “CTA” scheduled to look at heart arteries… does this also look for PE?
No, this is a different kind of CTA. It has to do with the timing. In the scan you are having, the technologist will start the injection of contrast and there will be a time delay until the scan begins. The delay is the time it takes for the contrast to get to the arteries of the heart. By that time, the contrast has already passed through the pulmonary arteries.
Hi
The million dollar question: is CT scan without dye contrast can detect blood clots or do you always need CT scan with dye contrast ?
yes, you need contrast to detect pulmonary embolism
Plz describe the iv contrast pathway through the body
If it comes from the upper extremity, it will go to subclavian vein > brachiocephalic vein > svc > right atrium > right ventricle > pulmonary artery > pulmonary vein > left atrium > left ventricle > aorta
My doctor recommended pulmonary angio ct ....wud it be helpful to detect covid if present???
Depends on why you need it. Recommendations about using CT to detect COVID-19 vary by region. It is not used as a primary tool for diagnosis here because of the superiority of the laboratory test and because by getting a CT, you could potentially be exposing others to COVID.
@@ThoracicRadiology since mid march i am having chest pain back pain and mild cough... recently started getting weakness....i know its asymptomatic covid but doctors says that u dont have fever u will not be tasted....my chest pain still persist.. frustrated i went to pulmonologist and he did my 2d cardio...it was clear hence i plead him to get ct scan he wrote pulmonary angio ct scan....so my question is... whether it wud show lung infection if present...???
I am lntenist, this vidieo very helpful
My doctor recommended pulmonary ct ....wud it be helpful to detect covid if present???
sir where is your video about right ventricular strain??
I finally made the video. Here is the link: ruclips.net/video/QHYOuudasF0/видео.html
Tips for tech in locating pulmonary artery?
ruclips.net/user/shortsPZCkQaOkj_s?feature=share
Very interesting to see how doctors interpret these scans. Is this part of a normal doctors knowledge or is this just for lung specialists?
I had one of these scans done on the NHS. When I asked them to show me the scan my reaction was pretty much: "What. That's it?! How can you even see that?".
Luckily it was a pretty small one. But it kept me a wake all night with a pain I just couldn't attribute to normal exhaustion. So I called 999.
I'm only 22. This should not have happened. I've been the epitome of a lazy oaf.
I've learned now how lucky I got considering the real possibility of stroke and imminently fatal PEs. Really puts into perspective how much I need to change my lifestyle.
MAJOR Big ups to the serious geniuses who work day and night to deal with this increasingly unhealthy populace.
I stopped the blood thinner meds they gave me of my own volition. From a personal value assessment.
Radiologists specialize in interpreting imaging. Some non-radiologists with time and initiative can learn to pick up obvious abnormalities from experience. But we still leave it to the radiologists for the final report.
Doctor, I am 36yr female and had COVID. After 3 weeks I started chest pain. I had 3 Chest XRAYs and a CTPA. Does is causes any risk for future Cancer?
Hi, if you are referring to the 3 chest x-rays and CTPA, the amount of radiation that you likely received is not high enough for us to measure any increased risk of cancer.
@@ThoracicRadiology Thanks a lot Doctor for your reply.
@@ThoracicRadiology hi im debating if I should get the angiogram where I get blood drawn instead of the ct if I get the ct will it be just a effective as the other angiogram with detecting if I have heart issues and so forth?
@@ThoracicRadiology basically is this just as effective as the other angiogram I just wanted to know
Thank u , but i didnt understand last minute in the video , when u discussed the artifact , if u see a hypodense arteries , slide back to make sure that you r in pulmonary artery not a vein , my question how to know i am in Pulmonary artery not a vein , am a beginner and learning from you , so i dont know....
Secondly , what u mean by going to Lung window and check its not Heart Motion artifact? What is Motion artifact ?
You have to trace the vessel back to it's origin. If it traces back to the left atrium, then it is a pulmonary vein. If it traces back to the pulmonary artery, then it is an artery.
Motion artifact is what happens when you take an image of something that is moving. Like when you take a photo but your subject moves, it will be blurry. Same for CT.
@@ThoracicRadiology ohh got it , thank u so much for taking the time to reply , so if someone moves during CT Angio , it may give false hypodense spots (pulm artery branches)
@@ThoracicRadiology but how to not confuse a real hypodense spot (clots in pulm art. branches) with a case when the dye didnt reach totally the peripheral branches of the pulmonary artery , giving a hypodense spots mimicing clots while its just the dye didnt reach that area?
@@christfollower5713 sometimes you can't tell
how to look at cardiac motion in 9:35 , thx
yeah the LV looks weird, but that is just the muscle wall
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Hey, i need a ask a thing in my exam.When we start to take images with contrast?A) descending aortB)ascending aortC)right ventriculeD)left ventriculeE)right atrium
Please answer quickly i need so much :( sorry for low english
Hi, I'm sorry I don't understand the question.
If you mean the ROI for monitoring; the answer is B. Ascending Aorta
guessing that exam didn't score too well my friend
@@MrHuddo yeah XD I graduated somehow but then I listened my inner voice and I'm studying Art and Design Master now hahahaha
Hello sir I am starting my Radiology residency..
How should I start studying
Start by getting a broad overview of a topic before delving into the details. Also go home and read about new diseases or topics that you see at work each day.
ruclips.net/video/scdhULJW52M/видео.html
2 kinds of motion lung, cardiac,
I have done 3 ctpa but all negative I am only 22 whats the risk of cancer . I always feel neck pain and brain pressure
3 CTPAs, assuming you had them literally at the same time (highest risk scenario possible), would expose you to around ~40 mSv of effective total radiation dose. Effective dose = the addition of equivalent doses to all organs, each adjusted to account for the sensitivity of the organ to radiation. Your abdomen (home to most of your body's organs), contains your bowel. The lining and walls of your bowel require daily relatively rapid regeneration. During regeneration, aka mitotic division, there is a certain window of time during the division where your DNA are more prone to the ionizing effects of CT X-rays, which may in rare rare instances lead to a neoplasm. Smoking cigarettes also does the same but in a much more systemic manner. Are you scared of smoking a cigarette? Just like X-rays (CT), the likelihood of positively diagnosed cancer depends tremendously on the amount you smoke (number of CT scans you have - in this analogy) over a given time you smoke a packet of cigarettes (one packet/scan daily? weekly? monthly?)
In short: Your chance, including mine, of developing cancer for no known reason is 37.5%. Assuming that you received 3 CTPAs in a row, back-to-back (illegal), your chance of developing cancer in addition to your baseline chance of 37.5% rises to 38.26%. That is an increase of 0.76% over the baseline conditions; i.e., under the assumption you had chosen not to undertake those 3 CTPAs.
In reality, you likely had these CTPAs done much further apart in time than on the same day. That decreases the 0.76% additional cancer risk DRAMATICALLY.
It's all about where the scan was done on your body, what dose was used by the technologist (auto-calculated almost always), and how much time had passed since having your previous scan.
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why scan is caudocranial direction
Sagar Idate hi, it is generally caudocranial because pulmonary embolism are more common in lower lungs and patient may have harder time breathing. If they go craniocaudal, patient may lose breath hold and you will lose the bases because of motion
@@rishi989 you dont have flash ct scanner?
@@srebro8924 hi there, we do but not all scanners in the system are flash. Some are still on the older side. Thanks for your question.
As the radiologist said, this definitely was not the best scan. It could've been caused by a number of different factors. The patient could just have poor cardiac output, they may have taken a deep breath in and it washed the contrast out, the scanner and or technologist didn't trigger the scan at the right time, or the scanner just is not quick enough (ie it's a 16 slice or older)
While I don’t have an account of what PE feels like - I imagine it must be very scary not to be able to breathe normally - please take this with a grain of salt as I’m just going where logic takes me.
“We conclude that asymptomatic pulmonary embolism is a common event in the populations studied.”
Asymptomatic pulmonary embolism. A common event in high risk patients, 1982
So is this just another moneymaker for hospitals? All they do is inject fibrinolytics. It is inconceivable to me that a blood clot large enough could form that would block the whole pulmonary artery. So worst case would be one lung partially blocked, so while the embolism clot hasn’t dissolved yet, the body has to have do with one lung. Furthermore, lung infarction because of the embolism is also unlikely, because the body has a backup perfusion to the lungs, the bronchial circulation. (Similar to the circle of Willis backup I suppose). So only when the bronchial circulation has become too weak to support the lungs until the blood clot resolves, like in geriatric patients, would this be a problem. Which is probably where the 40k death cases of PE come from.
And sure enough, there is also what seems to be a backup system for the brain when a smaller clot blocks an artery beyond the circle of Willis. Would have been pretty dumb of the body to be ok with a big clot but have an infarction on a small clot. leptomeningeal collateral circulation.
I won’t be surprised at all if migraines are just blood clots in the brain, without calling it a stroke because the brain tissue doesn’t die per above.
“seems that migraine and stroke might both be triggered by hypoperfusion and could therefore exist on a continuum of vascular complications”
Migraine aura pathophysiology: the role of blood vessels and microembolisation, 2010
During migraine attacks, the blood is more clottable:
CHANGES IN BLOOD CLOTTING SYSTEMS DURING MIGRAINE ATTACKS, 1977
Very nice video sir ❣️
should we contact on Instagram or whatsapp ?
hi, I'm not really active on those apps
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