Cardiac CT Board Exam - Coronary Arteries
Questions and Correct Answers
Question 1
when evaluating coronary arteries on cCTA which of the following provides greatest
diagnostic accuracy
a. MIP and oblique MPR
b. curved MRP and axial source images
c. thick MIP and curved MPR
d. axial source images and oblique MPR
Correct Answer
d. axial source images and oblique MPR
interactive MPRs permits higher diagnostic accuracy than pre-rendered images
(curved MPR, curved MIP, or VRT images)
Question 2
which of the following does the IMA most commonly originate?
a. ascending Ao
b. descending Ao
c. Subclavian artery
d. thyroid artery
Correct Answer
c. Subclavian artery
LIMA from Lt Subclavian
RIMA from braciochepalic (innominate) artery
Page 1 of 71
,Question 3
in a pt who has 4 venous bypass grafts in total, LAD , diag, OM and PDA, the graft to
which vessel typically arises from the topmost (most cranial) aortic anastomosis?
a. Diag
b. LAD
c. OM
d. PDA
Correct Answer
c. OM
topmost graft is usually the graft to the LCX (otherwise grafts would have to cross
over eachother). the graft to the RCA is usual the most Caudal anastomosis (closest
to the Ao valve)
Question 4
Image shows
a. calc ventricular aneyrusm
b. LAD stent
c. CAC
d. none of the above
Correct Answer
d. none of the above
pap muscle caclc
Question 5
66m hx of RCA stents presents with reccurnt CP. which is the next step in evaluation
a. CCTA using prosepective ECG triggering
b. CTCTA using retrospective ECG gaiting
c. CMRA
d. myocardial stress testing
Correct Answer
d. myocardial stress testing
Page 2 of 71
,Question 6
69 M underwent 3V CABG 2 years ago. He currently feels well and exercises regularily.
He recently heard about CCTA and was told it was useful for evaluating grafts. He asks
is there a benifity to undergoing CCTA. Which is the BEST response.
a. no becasue only clear indication for CCTA for assessment of grafts patentcy is at at
least 5 years after surgery.
b. no because CCTA should only be recommended for symptoamtic patients
c. yes becasue CCTA has excellent sensitiviy and specicifity to eval stensoso/occlusion
of grafts
d. yes because CCTA is considered appropriate for survellience of grafts
Correct Answer
b. no because CCTA should only be recommended for symptomatic patients
Question 7
which of the following describes how a CAC by agatson is computed
a. sum of area multiplied by a density coeficient
b. number of pixels with at least 130 HU attentuation
c. sum of area with pixels with at least 130 attenuation
d. number of pixels with at least 150 HI
Correct Answer
a. sum of area multiplied by a density coeficient
Ca is assumed present if at least 2 adjacent pixels have a density greater than 130
HU
for each calcified lesion, the area of all pixels greater than 130HU is multipled by a
coefficeint that is derived from the peak density aof that lesion.
Page 3 of 71
, Question 8
which of the following statements describes the value of CAC (agatson score)
a. it accurately predicts cardiovascular events in a given individual
b. it accurately assess the presence or absence of CAD
c. it does not require additional risk assessment for establishing prognosis
d. it provides incremental prognostic info over Framingham risk
Correct Answer
d. it provides incremental prognostic info over Framingham risk
Question 9
63 M w CP. image shows a lesion of th eLAD and the D2. an adv of CCT over invasive
angiography in the eval of this lesion is the avoidance of:
a. plaque blooming
b. lesion foreshortening
c. motion artifact
d. inaccurate stenosis quantification
Correct Answer
b. lesion foreshortening
Question 10
a CCTA on 62 M with recurrent CP one year after stents. based on the images what is
correct regarding stent patency.
a. the stent appears patent without sig ISR
b. the stent appears totally occluded
c. stent patency cant be characterized because stent was placed in small vessel
d. stent patency cant be evaluated with CCTA
Correct Answer
a. the stent appears patent without sig ISR
stent is larger than 3.5 mm and can be evaluated by CCTA
Page 4 of 71
Questions and Correct Answers
Question 1
when evaluating coronary arteries on cCTA which of the following provides greatest
diagnostic accuracy
a. MIP and oblique MPR
b. curved MRP and axial source images
c. thick MIP and curved MPR
d. axial source images and oblique MPR
Correct Answer
d. axial source images and oblique MPR
interactive MPRs permits higher diagnostic accuracy than pre-rendered images
(curved MPR, curved MIP, or VRT images)
Question 2
which of the following does the IMA most commonly originate?
a. ascending Ao
b. descending Ao
c. Subclavian artery
d. thyroid artery
Correct Answer
c. Subclavian artery
LIMA from Lt Subclavian
RIMA from braciochepalic (innominate) artery
Page 1 of 71
,Question 3
in a pt who has 4 venous bypass grafts in total, LAD , diag, OM and PDA, the graft to
which vessel typically arises from the topmost (most cranial) aortic anastomosis?
a. Diag
b. LAD
c. OM
d. PDA
Correct Answer
c. OM
topmost graft is usually the graft to the LCX (otherwise grafts would have to cross
over eachother). the graft to the RCA is usual the most Caudal anastomosis (closest
to the Ao valve)
Question 4
Image shows
a. calc ventricular aneyrusm
b. LAD stent
c. CAC
d. none of the above
Correct Answer
d. none of the above
pap muscle caclc
Question 5
66m hx of RCA stents presents with reccurnt CP. which is the next step in evaluation
a. CCTA using prosepective ECG triggering
b. CTCTA using retrospective ECG gaiting
c. CMRA
d. myocardial stress testing
Correct Answer
d. myocardial stress testing
Page 2 of 71
,Question 6
69 M underwent 3V CABG 2 years ago. He currently feels well and exercises regularily.
He recently heard about CCTA and was told it was useful for evaluating grafts. He asks
is there a benifity to undergoing CCTA. Which is the BEST response.
a. no becasue only clear indication for CCTA for assessment of grafts patentcy is at at
least 5 years after surgery.
b. no because CCTA should only be recommended for symptoamtic patients
c. yes becasue CCTA has excellent sensitiviy and specicifity to eval stensoso/occlusion
of grafts
d. yes because CCTA is considered appropriate for survellience of grafts
Correct Answer
b. no because CCTA should only be recommended for symptomatic patients
Question 7
which of the following describes how a CAC by agatson is computed
a. sum of area multiplied by a density coeficient
b. number of pixels with at least 130 HU attentuation
c. sum of area with pixels with at least 130 attenuation
d. number of pixels with at least 150 HI
Correct Answer
a. sum of area multiplied by a density coeficient
Ca is assumed present if at least 2 adjacent pixels have a density greater than 130
HU
for each calcified lesion, the area of all pixels greater than 130HU is multipled by a
coefficeint that is derived from the peak density aof that lesion.
Page 3 of 71
, Question 8
which of the following statements describes the value of CAC (agatson score)
a. it accurately predicts cardiovascular events in a given individual
b. it accurately assess the presence or absence of CAD
c. it does not require additional risk assessment for establishing prognosis
d. it provides incremental prognostic info over Framingham risk
Correct Answer
d. it provides incremental prognostic info over Framingham risk
Question 9
63 M w CP. image shows a lesion of th eLAD and the D2. an adv of CCT over invasive
angiography in the eval of this lesion is the avoidance of:
a. plaque blooming
b. lesion foreshortening
c. motion artifact
d. inaccurate stenosis quantification
Correct Answer
b. lesion foreshortening
Question 10
a CCTA on 62 M with recurrent CP one year after stents. based on the images what is
correct regarding stent patency.
a. the stent appears patent without sig ISR
b. the stent appears totally occluded
c. stent patency cant be characterized because stent was placed in small vessel
d. stent patency cant be evaluated with CCTA
Correct Answer
a. the stent appears patent without sig ISR
stent is larger than 3.5 mm and can be evaluated by CCTA
Page 4 of 71
