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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
Introduction
1 topic, 1 min.
Lesson
Advanced Coronary Anatomy
4 topics, 17 min.
Lesson
Myocardial Anatomy and Physiology
4 topics, 18 min.
Lesson
Technique and Protocols
2 topics, 6 min.
Lesson
CAD-RADS and Reporting Guidelines
3 topics, 17 min.
Lesson
Case Review: Overview
4 topics, 25 min.
Optimal Use of Ambra to Review Coronary CT Cases in this Course
7 m.Approach to Reading Coronary CT in Patients with Known CAD: Assessing Image Quality
7 m.Approach to Reading Coronary CT in Patients with Known CAD: Evaluating Coronary Arteries
10 m.Approach to Reading Coronary CT in Patients with Known CAD: Additional Testing
4 m.Lesson
Case Review: Stenosis
17 topics, 1 hr. 38 min.
Moderate Stenosis
8 m.Severe Stenosis, Single Vessel
7 m.Severe Stenosis, Complex Disease With CT-FFR Discrepancy
8 m.Severe Stenosis, Complex Disease (Obtuse Marginal Branch)
9 m.Moderate Stenosis in the Mid-LAD
4 m.Native Coronary Aneurysm
3 m.Stent Occlusion
8 m.Total Occlusion
9 m.Total Occlusion, Complex Disease
7 m.Severe Stenosis With Serial Lesions, Known MI, High-risk Patient
8 m.Severe Stenosis With Serial Lesions, Emergency Chest Pain
7 m.Moderate Stenosis With Serial Lesions
5 m.Role of CT FFR in Translesional Gradient Evaluation, Low-risk Patient in Mid-40s
6 m.Role of CT FFR in Translesional Gradient Evaluation, Setting of a Stent
4 m.CT FFR Limitation: Small Vessel Caliber
4 m.CT FFR Limitation: Motion Artifact (Case 1)
6 m.CT FFR Limitation: Motion Artifact (Case 2)
3 m.Lesson
Case Review: Bypass Grafts (CABG)
6 topics, 37 min.
Lesson
Case Review: Sequelae of Ischemic Coronary Disease
5 topics, 15 min.
Lesson
Case Review: Post-myocardial Infarction Complications
7 topics, 17 min.
Lesson
Case Review: Planning for Coronary Interventions
6 topics, 33 min.
Lesson
Conclusion
1 topic, 2 min.
0:00
Next case is a relatively young patient who, um,
0:03
had had a PI prior bypass graft surgery.
0:06
Um, and although I've not selected the perfect motion
0:09
for you phase here, I just wanted to show you
0:10
that there's a bypass graft from the aorta to the RCA,
0:14
so aorta coronary,
0:15
and then there's a bypass graft to the Lima, LAD
0:20
and some additional extensive disease.
0:23
But what I really wanted to focus on
0:25
is the left ventricular apex.
0:28
So again, we're gonna go to our long axis planes
0:31
and something that the reader very astutely picked up on was
0:34
that there's some contour abnormality here.
0:36
Now this is a gating artifact,
0:38
but there's also some thinning
0:39
and disproportion to the expected wall thicknesses, even
0:43
for a ventricular apex.
0:45
So if I don't have a perfect image due to gating,
0:48
but I have another scan, which in this case I do, um,
0:51
I can look at this non gated scan and I see it just as well.
0:54
There's wall thinning there. So this is some area you can
0:57
look at and here it is on a delayed image,
1:01
see similar plane, and you can
1:02
really see this wall thinning there.
1:03
So that's a small, uh,
1:05
distal apical aneurysm of the left ventricle.
1:08
So if I see anything like this,
1:10
I'm gonna look at a delayed image
1:11
and I'm gonna try to make sure I don't miss anything like a
1:14
small thrombus.
1:17
And those are just normal papillary
1:19
muscles and trabeculation.
1:20
So thinning consistent with a tiny apical aneurysm,
1:24
but not evidence of thrombus in the setting
1:26
of extensive known coronary disease.
Ventricular Aneurysm (Case 1)
HIDEInteractive Transcript
0:00
Next case is a relatively young patient who, um,
0:03
had had a PI prior bypass graft surgery.
0:06
Um, and although I've not selected the perfect motion
0:09
for you phase here, I just wanted to show you
0:10
that there's a bypass graft from the aorta to the RCA,
0:14
so aorta coronary,
0:15
and then there's a bypass graft to the Lima, LAD
0:20
and some additional extensive disease.
0:23
But what I really wanted to focus on
0:25
is the left ventricular apex.
0:28
So again, we're gonna go to our long axis planes
0:31
and something that the reader very astutely picked up on was
0:34
that there's some contour abnormality here.
0:36
Now this is a gating artifact,
0:38
but there's also some thinning
0:39
and disproportion to the expected wall thicknesses, even
0:43
for a ventricular apex.
0:45
So if I don't have a perfect image due to gating,
0:48
but I have another scan, which in this case I do, um,
0:51
I can look at this non gated scan and I see it just as well.
0:54
There's wall thinning there. So this is some area you can
0:57
look at and here it is on a delayed image,
1:01
see similar plane, and you can
1:02
really see this wall thinning there.
1:03
So that's a small, uh,
1:05
distal apical aneurysm of the left ventricle.
1:08
So if I see anything like this,
1:10
I'm gonna look at a delayed image
1:11
and I'm gonna try to make sure I don't miss anything like a
1:14
small thrombus.
1:17
And those are just normal papillary
1:19
muscles and trabeculation.
1:20
So thinning consistent with a tiny apical aneurysm,
1:24
but not evidence of thrombus in the setting
1:26
of extensive known coronary disease.
Report
Faculty
Brian Ghoshhajra, MD, MBA, MSCCT
Academic Chief, Cardiovascular Imaging and Associate Chair, Operations Analytics
Massachusetts General Hospital / Harvard Medical School
Tags
Vascular
Myocardium
Coronary arteries
Cardiac Chambers
Cardiac CT (SCCT Cat B1 Video Case)
Cardiac
CTA
CT
Angiography
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