Real World Emergency Department Cardiac CTA

Welcome to the Real World Emergency Department Cardiac CTA course on RadIQ! All fifty cases collected here were acquired in the emergent clinical setting on patients presenting to the Massachusetts General Hospital emergency department with symptoms concerning for acute coronary syndrome(ACS). The TIMI risk score is listed for each patient, all of whom were classified as low to intermediate risk for ACS, had negative serum cardiac biomarkers and had an EKG without ischemic changes prior to undergoing the scan.

The user will grade individual vessels for stenosis and then utilize the CAD-RADs scoring system to give an overall score to the CTA. Correlative invasive coronary angiography images will then be viewed which will also be scored. When grading individual vessel stenosis, please use the following values:

None: no coronary artery disease

Mild: 1 – 49% stenosis

Moderate: 50 – 69% stenosis

Severe: 70 – 100% stenosis

Teaching slides at the conclusion of the case will illustrate the key lesions and associated teaching points.

IMPORTANT: These modules must be viewed in Google Chrome to see the teaching slides in full size. When the teaching slides are displayed, right click on each and choose “View in New Tab” to see in full size.

Feedback is welcome and we hope this is an excellent learning experience for you!

Course set up:

The course consists of 50 cases. Each case consists of a completely scrollable DICOM dataset with multiple choice questions. Selected invasive angiography videos will then be displayed, also with multiple choice questions. Please answer all the questions. Once you have answered all the questions for the case, you will be presented with the feedback and teaching points. You can compare your answers against the correct answers for the case.

Please Note:

• After completing a case, you will not be able to go back and change your answers.
• After answering all 50 cases, you can opt for a complete retest, but you will have to complete all 50 cases again
• When you have completed all 50 cases, a tab will appear in the upper right hand corner that says “My Score”. Click here and then export the score file to Excel  to print.

Notes on using the MPR CT viewer:

• On the small multiplanar views to the left, hover to the center of the crosshairs untill you see an open hand; click and drag to re-center crosshairs.
• On the small multiplanar views to the left, hover to the center of the crosshairs untill you see a pointing hand; click and drag to rotate the crosshairs.
• Double click on any of the small multiplanar views on the left to make them the large primary image on the right.