Cardiac CT

ECG-gated contrast-enhanced coronary CT angiography on a Siemens SOMATOM Definition Edge 128. Visualises coronary arteries, quantifies stenosis, characterises plaque, and assesses left ventricular function non-invasively. Over 3,000 coronary CTAs performed at Neuromed.

Cardiac CT at Neuromed Timisoara delivers a comprehensive non-invasive coronary angiogram using a contrast-enhanced, ECG-gated acquisition on the Siemens SOMATOM Definition Edge 128. Over 3,000 coronary CT angiographies have been performed at the centre since 1999 — a volume that places Neuromed among the most experienced cardiac CT programmes in south-western Romania. The Siemens Training Centre accreditation received in 2008 formally recognised this subspecialty depth at an international level. The examination begins with ECG monitoring to assess heart rate. A resting rate below approximately 65–70 beats per minute produces optimal image quality; if the patient's rate is higher, beta-blockade may be administered by the team prior to scanning. A peripheral intravenous cannula is placed for the iodine-based contrast agent, which is delivered via a powered injector at a precisely timed bolus-tracking protocol. As the contrast perfuses the coronary arteries, the scanner sweeps the heart in a narrow, ECG-triggered acquisition window. Neuromed applies 4D care-dose and modulated ECG scanning — technical approaches that reduce radiation dose by modulating tube power throughout the cardiac cycle, delivering full output only during the diastolic window when the arteries are most clearly visible. This brings the total radiation dose for a coronary CTA to approximately 6–8 mSv, comparable to two to three years of natural background radiation in Europe rather than the higher doses associated with older CT protocols or with conventional invasive catheter angiography. The resulting dataset supports several levels of analysis: quantification of luminal stenosis at each coronary segment, characterisation of plaque composition (calcified versus non-calcified, lipid-rich versus fibrous), and functional assessment of the left ventricle including ejection fraction, end-systolic and end-diastolic volumes, and regional wall motion. The examination also images coronary bypass grafts, stents, pacemaker leads, and the valves, making it useful for postoperative surveillance as well as initial diagnosis. Congenital coronary anomalies and complex cardiac anatomy can be mapped in three dimensions before surgical or interventional planning. Preparation requires patients to provide recent blood tests (creatinine and TSH values within approximately one week) to confirm suitability for iodine contrast, to avoid caffeine for 24 hours before the examination, and to abstain from alcohol for 48 hours. Patients on PDE-5 inhibitors should discontinue these for 72 hours before the study. Adequate hydration before and after the scan supports contrast clearance. The clinic's contact number is +40 256 292 637.