How is a coronary CTA examination reviewed?
Initially, the noncontrast images are reviewed for lung and mediastinal pathology. A coronary calcium score is calculated. Then, the coronary CTA images are reviewed. From the raw data of the CTA data acquisition, multiple reconstructions may be generated in various phases of the cardiac cycle (if retrospective gating was used). The reconstructed images are typically reviewed at a dedicated workstation in the axial plane and via multiplanar reformatted (MPR) images generated by the interpreting physician to best depict the arteries. The myocardium, cardiac valves, pericardium, and extracardiac structures are also thoroughly evaluated. More advanced workstation functions, such as curved planar reformation of the coronary arteries, may be used as an aid to interpretation but are not used to replace analysis of the entire dataset by the radiologist. Finally, if retrospective gating was employed, a cine sequence of the heart is reconstructed to evaluate cardiac wall motion and to calculate ejection fraction.