Decreasing peak tube voltage from 120 to 100 kVp
Decreasing tube current from 500 to 400 mAs
Increasing collimation from 64 x 0.5 to 32 x 1mm
Decreasing pitch from 0.3 to 0.2
Increase pitch from 0.2 to 0.4
Prospective ECG-triggering instead of retrospective ECG-gating
Dual source CT and retrospective ECG-gating
Increase scan coverage
Minimize radiation dose
Obtain adequate temporal resolution
Achieve high z-axis resolution and avoid volume averaging
Reconstructed slice width
In axial scanning mode, each detector row is dedicated to one z-axis slice per gantry rotation
In axial scanning mode, each detector row is dedicated to multiple z-axis slice levels per gantry rotation
In helical scanning mode, each detector row is dedicated to one z-axis slice level per gantry rotation
Each detector row is always dedicated to one z-axis slice level per gantry rotation, in either axial or helical scanning mode.
Proceed with scan without sublingual nitroglycerin
Proceed with the scan with sublingual nitroglycerin
Reschedule his test for next day
Consider alternate testing
Perform scan without beta-blocker using retrospective gating
Use a short-acting IV metoprolol immediately prior to scan
Use a long-acting oral metoprolol one hour before the scan
Cancel the study and consider alternative diagnostic test
Calcium score >400
All of the above
Patients admitted for a ST elevation MI and have positive Troponin
Patients with borderiine or equivocal positive stress tests
Patient with atypical chest pain, a LBBB of unknown duration, with normal serial cardiac enzymes
Patients who are admitted to rule out MI, with negative biomarkers (negative Troponin)
The ability to reconstruct overlapping slices for increased z-axis resolution.
Considerably less radiation exposure.
Ability to calculate ejection fraction.
Arrhythmias are less likely to cause image artifacts.
Faster contrast injection
Larger contrast volume
Higher tube current
Thinner slice collimation