With the Cardiac Lecture Series: Intermediate, you will build on the skills you learned in the basic lecture series and gain greater insight into the foundation of cardiac imaging.

Global Lectures Series Objectives:

• Provide a standardized foundation for the learning of normal cardiac anatomy and physiology and common anatomic variants.

• Review the basic principles of cardiac imaging, to include chest radiography and CT, cardiac-gated multi-detector CT (MDCT), and MR imaging.

• Assess common congenital and acquired heart diseases.

• Facilitate the recognition and diagnosis of common cardiac diseases, to include associated pulmonary vascular patterns, abnormalities of cardiac size and configuration, pulmonary embolism, non-traumatic acute aortic syndromes, and MDCT evaluation of acute chest pain.

Buy 8 Cardiac Intermediate Lectures – Approved for 4.25 AMA/PRA Category 1 credit(s) ™

Buy the other 14 Cardiac Intermediate Lectures – NO CME available

1. Recognizing and Avoiding Artifacts in Coronary MDCT Angiography
2. Initial Results of Dual Source Computed Tomography for Coronary Visualization
3. Coronary MDCT Angiography: Results and Clinical Applications
4. Coronary calcium scoring: is there ANY role?

1. Recognizing and Avoiding Artifacts in Coronary MDCT Angiography -

• Describe common coronary CT angiography artifacts and pitfalls.
• Suggest imaging and post-processing strategies to optimize imaging quality.
• Reduce motion artifact by decreasing the heart rate and by selecting the optimal cardiac phases for image reconstruction.
• Identify calcium artifacts by using multiplanar reconstruction and avoiding motion.
• Assess luminal narrowing by utilizing multiplanar reconstructions

2. Initial Results of Dual Source Computed Tomography for Coronary Visualization -

• Explain how higher true temporal resolution can significantly improve CT coronary angiography without using beta blockers.
• Describe how dual source CT can reduce motion artifacts.
• Explain how to achieve optimal phase for image construction.
• Identify theoretical possibilities for Dual Energy CT to reduce artifacts and lower radiation doses.

3. Coronary MDCT Angiography: Results and Clinical Applications -

• Explain the utility and reliability of coronary CT angiography to exclude significant coronary stenosis.
• Compare the accuracy of 64 slice CT with invasive angiography for detecting stenosis.
• Based on the clinical scenario, determine the pretest likelihood of coronary artery disease and possible treatment options.
• Identify the limitations of coronary CT angiography in high risk patients with extensive calcified plaque or coronary bypass grafts or stents.
• Describe current applications of coronary CT angiography.

4. Coronary calcium scoring: is there ANY role? -

• Describe the main application of coronary calcium identification and quantification.
• Explain how the Agatston score describes the distribution of coronary artery calcium in the general population.
• Review the studies that indicate the undisputed relationship between the amount of coronary calcium and coronary event risk in asymptomatic patients.
• State the importance of calcium plaque and the risk for myocardial infarction.

1. Cardiac CT and MRI, Competition or Complementary?
2. Starting and Running a Clinical Practice
3. CT of Coronary Stents and Bypass Grafts
4. Surgical approach to coronary artery disease- What radiologists need to know

1. Cardiac CT and MRI - Competition or Complementary? -

• Learn basic capabilities and limitations for cardiac CT and MRI
• Understand which modality may be optimal for specific clinical questions

2. Starting and Running a Clinical Practice -

• Understand different practice models for performing coronary CT angiography
• Learn options for credentialing coronary CT readers

3. CT of Coronary Stents and Bypass Grafts -

• Learn the changing clinical use of CABG and stents.
• Understand the use and limitation of coronary CT for stent evaluation.
• Understand the use and limitation of coronary CT for coronary bypass graft evaluation

4. Surgical Approach to Coronary Artery Disease- What Radiologists Need To Know -

• Discuss importance of CT reconstruction to cardiac surgeon
• Demonstrate anomalous coronary arteries

Cardiac Anatomy -

• Identify and name normal and anomalous origins of coronary arteries and major branches
• Describe and determine coronary artery dominance
• Recognize normal cardiac anatomy and common anatomic pitfalls on CT

Pericardial Imaging -

• Review the normal pericardial anatomy, fluid, recesses, and sinuses
• Discuss the implications of congenital pericardial defects, pericardial effusion, constrictive pericarditis, and primary and secondary pericardial neoplasms

Cardiovascular Findings on Non-contrast Chest CT -

• Utilize routine chest CT to detect ectopic or absent normal structure
• Optimize narrow CT windows to accentuate differences in tissue density to detect parenchymal hemorrhage
• Detect focal edema, collateral vessels, or altered cardiac chamber size as secondary features of altered cardiopulmonary hemodynamics

Cardiac MDCT: Image Post-Processing -

• Post-process the raw axial CT data at various phases of the cardiac cycle to reconstruct multi-planar reformat (MPR), curved reformat (CR), maximum intensity projection (MIP) and volume rendered (VR) images to optimize interpretation of the coronary arteries
• Detail the post-processing techniques of EGC-gating and 2-D and 3-D imaging, with emphasis on the benefits and limitations of each

Cardiac MDCT in Atrial Fibrillation and Cardiac Resynchronization -

• Discuss the epidemiology and treatment options of patients with atrial fibrillation (AF), with emphasis on radiofrequency ablation (RFA) of the left atrium for patients with refractory AF
• Utilize cardiac MDCT in the pre-operatively evaluation of patients in preparation for RFA
• Emphasize incidental pre-operative findings and post-operative RFA complications that may impact patient management
• Review cardiac vein anatomy and imaging strategies to facilitate cardiac resynchronization therapy and pacemaker placement

Comparison of Cardiac Imaging Modalities: The Cardiologists' Perspective -

• Describe the benefits and shortcomings of the traditional imaging modalities used to assess cardiology patients
• Evaluate how coronary CT may complement cardiac echocardiography, stress imaging and positron emission tomography and coronary angiography in patients with known or suspected heart disease

Radiation Dosimetry and Approaches to Reduce Radiation Dose -

• Delineate the biologic effects, measurement parameters, and determinants of radiation dose that results from diagnostic ionizing radiation
• Compare the radiation exposure from environmental sources and various diagnostic cardiac imaging studies
• Discuss practical techniques to reduce radiation dose, to include optimal field of view, utilization of the lowest tube current and voltage consistent with diagnostic image quality, ECG-controlled tube current modulation, and dual-source CT scanners

CTA for Chest Pain in the ED: Are We There Yet? -

• Describe the stratification of patients who present to the emergency room with chest pain
• Review conventional imaging approaches to assess chest pain, to include chest radiography and cardiac stress testing
• Discuss the potential utility of CTA in chest pain evaluation

Cardiac MDCT: Protocols -

• Describe the two standard components of a conventional cardiac coronary artery CT study: the unenhanced, prospectively ECG-gated calcium scoring exam and the contrast-enhanced, retrospectively ECG-gated evaluation of the coronary arteries and heart
• Optimize pharmacologic intervention to slow the heart rate and dilate the coronary arteries (Metoprolol and sublingual nitroglycerin), perfect the biphasic or triphasic contrast enhancement of the coronary arteries, and discuss scanning protocols

Pathophysiology and Natural History of Coronary Atherosclerosis -

Cardiac CT in the Early Triage of Patients with Acute Chest Pain -

• Evaluate the initial triage and risk stratification of patients with a suspected acute coronary syndrome
• Demonstrate the diagnostic accuracy, clinical utility, and cost effectiveness of MDCT in the evaluation of patients with suspected acute coronary syndrome

Cardiac Embryology for the Radiologist -

Common Surgical Procedures for Congenital Heart Disease -

Imaging Congenital Heart Disease in Adults -