2023-04-17 15:08:41
The co-scanner is a medical imaging examination using x-rays to obtain thin section images of the heart and arteries.
Definition: what is a coroscanner?
The coroscanner ( also called “coronary CT angiography” or “heart scan“) is a computed tomography examination painless and non-invasive that allows to observe with precision the arteries of the heart called “coronary arteries”.
This examination uses X-rays andinjection of an iodinated contrast medium. It has been practiced in cardiology for ten years.
The coroscanner makes it possible to measure risk of heart attack linked to deterioration of the coronary arteries through the evaluation of the calcium score. Nevertheless, this examination is not exhaustive and must often be supplemented by other types of imagery which make it possible to evaluate other compartments of the heart (coronarography, echocardiography, cardiac MRI, myocardial scintigraphy, etc.).
Calcium score, what is it?
The coronary calcium score is a numerical evaluation of the extent of atheromatous deposits (atheroma plaques) calcified observed at the level of the walls of the arteries of the heart, the coronaries. It is obtained thanks to the coroscanner. The calcium score provides information on the state of the arteries of the heart, the advance of atherosclerosis and the risk of heart attack.
What is the difference(s) between CT scan and coronary angiography?
Like the coroscanner, the coronary angiography makes it possible to obtain images of the coronary arteries. However, these two examinations are very different since, unlike CT scan, coronary angiography is very invasive. The latter is performed in the operating room in the presence of the cardiologist who will be able to perform an angioplasty or the placement of a stent if necessary.
Indications: why do we do a coroscanner?
The coroscanner makes it possible to detect coronary lesions: the type of lesions (occlusions, stenoses), and their severity. It also makes it possible to study atheromatous plaque (soft plaque, fibrous plaque, mixed plaque, calcified plaque). It therefore provides information on the risk of heart attack linked to artheroma plaques.
The main indications are in the context of pre-surgical assessments and in doubtful clinical pictures.
The CT scan may be prescribed in the event of:
- suspicious chest pain in patients in whom the stress test and/or the scintigraphy are uninterpretable or doubtful.
- atypical chest pain or dyspnea in a patient with multiple cardiovascular risk factors such as overweight, high blood pressure, smoking, dyslipidemia or a family history of cardiovascular events.
or in the course of surveillance or exploration:
- the patency of stents or coronary artery bypass grafts.
- of cardiomyopathy.
- valvular pathology such as biscupidia or calcified aortic stenosis.
- cardiac masses.
- pericardial sheets.
Are there any contraindications to coroscanner?
There are some contraindications to coroscanner:
- an allergy to iodine;
- pregnancy and lactation;
- severe renal failure;
- unstable hemodynamic status;
- heart rhythm disorders (rapid atrial fibrillation, atrial or ventricular extrasystole);
- taking metformin in the context of diabetes;
- a contraindication to beta-blockers. ;
- Morbid obesity (BMI > 40 kg/m²);
- Hearing problems.
How to prepare for the exam? Should the CT scan be done on an empty stomach?
For the realization of the coroscanner, you must be fasting for 3 hours.
In case of iodine allergy, you will receive preventive treatment for 2 to 3 days before the examination.
If taking Metformin in the context of diabetes, this medication should be stopped for 48 hours.
On the day of the appointment, remember to bring:
- the vital card;
- the mutual card;
- a prescription from the prescribing physician;
- the iodized contract product;
- old X-rays if the examination has already been carried out;
- Any imaging examination or assessment likely to be related to the CT scan;
Don’t forget to mention if you are taking medication for asthma or if you are claustrophobic.
How is a CT scan done?
The patient is lying on the examination table, an infusion placed on a vein in his arm and electrodes glued to his chest. These electrodes allow the production of a electrocardiogram (ECG). The doctor will ask you to remain still during the entire examination and to stop breathing (apnea) in sequences of 15 seconds.
The administration of a short-acting beta-blocker drug to reduce the heart rate is most often necessary. In the event of a contraindication to beta-blockers, it is possible to carry out the examination without slowing down the heart.
The coronary CT scan lasts on average 15 minutes and it is totally painless. Only the injection of the contrast product can give an unpleasant impression of heat.
What are the risks and side effects of CT scans?
The CT scan is a painless, non-invasive and completely harmless examination. Nevertheless, the injection of contrast product can produce some side effects such as feeling of warmth in the throat and lower abdomen during the injection.
Please note that asthmatic patients may be confronted with a state of discomfort and at one asthma attack. A allergic reaction linked to the iodine contained in the contrast product is also possible.
Rest assured, these side effects remain infrequent.
Results: how is the report of the results of the coroscanner carried out?
During a CT scan, the radiologist recovers between 1000 and 2000 images which require computer processing before interpretation. After the examination, you will be received by the radiologist who will give you an initial assessment. The report (accompanied by 3D images) will be sent to you and to the prescribing doctor.
Where to do a CT scan?
Most medical imaging centers now perform coronary CT scans. Check with the medical centers in your area.
What is the cost of a coroscanner?
The coronary scanner costs around 150 euros, 70% covered by Social Security, provided that it has been prescribed by the attending physician. The remaining charge of 30% may be paid in whole or in part by your health insurance fund depending on the contract chosen. There may be overcharges at private imaging centers. Some mutuals cover these overruns.
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