EACVI CARDIAC COMPUTED TOMOGRAPHY PRACTICE EXAM LATEST QUESTIONS AND
CORRECT ANSWERS GRADE A
**1. What is the primary clinical indication for coronary CT angiography (CCTA)?**
A) Evaluation of acute chest pain in low-intermediate risk patients
B) Assessment of myocardial viability
C) Detection of intracardiac shunts
D) Evaluation of pericardial constriction
**Answer: A**
**Explanation:** CCTA is primarily indicated for evaluating stable chest pain in patients
with low to intermediate pretest probability of coronary artery disease (CAD), as per current
guidelines.
**2. Which of the following beta-blockers is most commonly used for heart rate control
prior to CCTA?**
A) Metoprolol
B) Atenolol
C) Propranolol
D) Carvedilol
**Answer: A**
**Explanation:** Intravenous metoprolol is most commonly used for acute heart rate
control prior to CCTA due to its rapid onset, short duration, and widespread availability.
**3. What is the optimal heart rate for coronary CT angiography?**
A) <60 bpm
,B) 60-75 bpm
C) 75-90 bpm
D) >90 bpm
**Answer: A**
**Explanation:** A heart rate <60 bpm is ideal for CCTA as it minimizes motion artifacts
and improves image quality, particularly with 64-slice and older CT scanners.
**4. Which vessel is typically the most challenging to evaluate on CCTA due to motion
artifacts?**
A) Right coronary artery
B) Left main coronary artery
C) Circumflex artery
D) Left anterior descending artery
**Answer: C**
**Explanation:** The circumflex artery courses along the atrioventricular groove and is
often affected by cardiac motion, especially from the adjacent left atrium.
**5. What is the primary advantage of dual-source CT technology for cardiac imaging?**
A) Improved temporal resolution (83 ms)
B) Higher spatial resolution
C) Lower radiation dose
D) Faster patient throughput
**Answer: A**
,**Explanation:** Dual-source CT systems have two x-ray sources and detectors offset by
90°, providing temporal resolution of 83 ms, which reduces motion artifacts without
requiring beta-blockers.
**6. Which reconstruction algorithm is most commonly used for coronary CT
angiography?**
A) Filtered back projection
B) Iterative reconstruction
C) Feldkamp algorithm
D) Radon transformation
**Answer: B**
**Explanation:** Iterative reconstruction reduces image noise and radiation dose while
maintaining image quality, making it the standard for modern CCTA.
**7. What is the typical slice thickness used for coronary artery evaluation?**
A) 0.5-0.75 mm
B) 1.0 mm
C) 1.5 mm
D) 3.0 mm
**Answer: A**
**Explanation:** Thin slices (0.5-0.75 mm) provide adequate spatial resolution for
evaluating coronary plaques and stenosis while balancing noise and radiation dose.
**8. Which parameter primarily determines the radiation dose in cardiac CT?**
A) Tube current (mA)
, B) Tube voltage (kV)
C) Pitch
D) Gantry rotation time
**Answer: A**
**Explanation:** Tube current (mA) directly correlates with radiation dose, though tube
voltage (kV) also significantly contributes. Modern systems use ECG-based tube current
modulation to reduce dose.
**9. What is the purpose of sublingual nitroglycerin administration prior to CCTA?**
A) Coronary vasodilation
B) Heart rate reduction
C) Blood pressure control
D) Contrast enhancement
**Answer: A**
**Explanation:** Nitroglycerin causes coronary vasodilation, improving visualization of
coronary luminal diameter and enhancing detection of stenoses.
**10. Which phase of the cardiac cycle typically provides the best image quality for
coronary evaluation?**
A) Mid-diastole (70-80% of R-R interval)
B) End-systole (30-40% of R-R interval)
C) Early diastole
D) Atrial systole
**Answer: A**
CORRECT ANSWERS GRADE A
**1. What is the primary clinical indication for coronary CT angiography (CCTA)?**
A) Evaluation of acute chest pain in low-intermediate risk patients
B) Assessment of myocardial viability
C) Detection of intracardiac shunts
D) Evaluation of pericardial constriction
**Answer: A**
**Explanation:** CCTA is primarily indicated for evaluating stable chest pain in patients
with low to intermediate pretest probability of coronary artery disease (CAD), as per current
guidelines.
**2. Which of the following beta-blockers is most commonly used for heart rate control
prior to CCTA?**
A) Metoprolol
B) Atenolol
C) Propranolol
D) Carvedilol
**Answer: A**
**Explanation:** Intravenous metoprolol is most commonly used for acute heart rate
control prior to CCTA due to its rapid onset, short duration, and widespread availability.
**3. What is the optimal heart rate for coronary CT angiography?**
A) <60 bpm
,B) 60-75 bpm
C) 75-90 bpm
D) >90 bpm
**Answer: A**
**Explanation:** A heart rate <60 bpm is ideal for CCTA as it minimizes motion artifacts
and improves image quality, particularly with 64-slice and older CT scanners.
**4. Which vessel is typically the most challenging to evaluate on CCTA due to motion
artifacts?**
A) Right coronary artery
B) Left main coronary artery
C) Circumflex artery
D) Left anterior descending artery
**Answer: C**
**Explanation:** The circumflex artery courses along the atrioventricular groove and is
often affected by cardiac motion, especially from the adjacent left atrium.
**5. What is the primary advantage of dual-source CT technology for cardiac imaging?**
A) Improved temporal resolution (83 ms)
B) Higher spatial resolution
C) Lower radiation dose
D) Faster patient throughput
**Answer: A**
,**Explanation:** Dual-source CT systems have two x-ray sources and detectors offset by
90°, providing temporal resolution of 83 ms, which reduces motion artifacts without
requiring beta-blockers.
**6. Which reconstruction algorithm is most commonly used for coronary CT
angiography?**
A) Filtered back projection
B) Iterative reconstruction
C) Feldkamp algorithm
D) Radon transformation
**Answer: B**
**Explanation:** Iterative reconstruction reduces image noise and radiation dose while
maintaining image quality, making it the standard for modern CCTA.
**7. What is the typical slice thickness used for coronary artery evaluation?**
A) 0.5-0.75 mm
B) 1.0 mm
C) 1.5 mm
D) 3.0 mm
**Answer: A**
**Explanation:** Thin slices (0.5-0.75 mm) provide adequate spatial resolution for
evaluating coronary plaques and stenosis while balancing noise and radiation dose.
**8. Which parameter primarily determines the radiation dose in cardiac CT?**
A) Tube current (mA)
, B) Tube voltage (kV)
C) Pitch
D) Gantry rotation time
**Answer: A**
**Explanation:** Tube current (mA) directly correlates with radiation dose, though tube
voltage (kV) also significantly contributes. Modern systems use ECG-based tube current
modulation to reduce dose.
**9. What is the purpose of sublingual nitroglycerin administration prior to CCTA?**
A) Coronary vasodilation
B) Heart rate reduction
C) Blood pressure control
D) Contrast enhancement
**Answer: A**
**Explanation:** Nitroglycerin causes coronary vasodilation, improving visualization of
coronary luminal diameter and enhancing detection of stenoses.
**10. Which phase of the cardiac cycle typically provides the best image quality for
coronary evaluation?**
A) Mid-diastole (70-80% of R-R interval)
B) End-systole (30-40% of R-R interval)
C) Early diastole
D) Atrial systole
**Answer: A**
