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Ramus intermedius artery stenosis

Case Study
CT Marketing Philips Healthcare

This 75-year-old female has a history of hypertension and presented with acute back and shoulder pain unrelated to physical strain or injury. Her electrocardiogram (ECG) was normal and lab results were within normal limits. She was referred to a cardiologist for evaluation where her workup included both CVCT and diagnostic coronary angiography.

 

Both exams clearly demonstrated a high-grade eccentric mid portion stenosis of the ramus intermedius artery. This vessel appears to be relatively large; both proximally and distally, it appears within normal limits. The CVCT portion of the exam identified both calcified and soft plaque in this artery. The disproportionate artery stenosis could be related to soft plaque vessel disease.

 

The ramus medianus or intermedius trifurcates from the left main coronary giving rise to this middle branch in only 15 % of the population. In most cases, the left main coronary artery divides into left anterior descending (LAD) and cimcumflex (LCX).

Scan parameters

  • 16 x .75 mm collimation
  • 0.2 pitch
  • 0.4 second rotation time
  • 140 kV
  • 399 mAs/slice
  • 0.8 mm thickness
  • 0.4 mm increment
  • C filter
  • 4 cc/second injection rate for a total of 150 cc's
  • 28 seconds total scan time for 145 mm coverage
 Volume-rendered image shows stenotic region of the ramus intermedius. Coronary angiography shows the stenotic region of the ramus intermedius.
Volume-rendered image shows stenotic region of the ramus intermedius.
Coronary angiography shows the stenotic region of the ramus intermedius.
 Fade-MIP demonstrates the trifurcation of the LAD, LCX and ramus intermedius. MasterCut of the ramus intermedius artery with visualization of soft plaque.
Fade-MIP demonstrates the trifurcation of the LAD, LCX and ramus intermedius.
MasterCut of the ramus intermedius artery with visualization of soft plaque.


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Jul 24, 2005

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Case Study
Brilliance 16-slice
back pain, Brilliance Version 1.2, calcification, Cardiac, cardiologist, coronary angiography, coronary arteries, hypertension, MIP, prospective, retrospective, stenosis
 

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