Prosedur Pemeriksaan MSCT Cardiac pada Klinis Heart Failure dengan Disertai Atrial Fibrilasi di Instalasi Radiologi RS Universitas Sebelas Maret

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Background:Cardiac MSCT is a CT scan examination that can show the structure of the heart chamber and blood vessels. The cardiac MSCT examination procedure in clinical heart failure accompanied by atrial fibrillation at the Radiology Installation of Sebelas Maret University Hospital uses a pitch parameter setting of 0.2 and selection of the contrast scanning reconstruction phase interval based on the results of the calcium score phase interval. This study aims to describe the cardiac MSCT examination procedure and the reasons for using the pitch parameter of 0.2 and determining the contrast scanning phase interval based on the results of the calcium score phase interval in clinical heart failure accompanied by atrial fibrillation. Method:This type of research is qualitative research with a case study approach. Data collection is carried out using observation, interview and documentation methods, then the data obtained is analyzed using an interactive data model, namely data collection, data reduction, data presentation and drawing conclusions. Results:Cardiac MSCT examination procedure in clinical heart failure accompanied by atrial fibrillation at the Sebelas Maret University Radiology Installation, the patient was not given betablocker drugs due to arrhythmia abnormalities. The protocol for this examination is topogram, calcium scoring and contrast cardiac scanning. Topogram parameters at 100 kV, and 60mA as high as the sternal notch to the diaphragm. Calcium scoring parameters at 80-90 kV, slice thickness 3mm with prospective ECG gatting method, scanning area for calcium scoring from the aortic arch to the cardiac basal. Cardiac contrast scanning parameters at 70-90 kV, slice thickness 0.8, tube rotation 0.33 and pitch 0.2 with an area from the aortic arch to the cardiac basal. Triggering scan is placed on the descending aorta as high as the main pulmonary artery. The use of a pitch of 0.2 can provide a longer ECG RR interval range in unstable patient pulses, thereby minimizing interpolation artifacts and facilitating the selection of contrast scanning reconstruction phase intervals. The use of calcium scorring phase interval results for selecting the contrast scanning reconstruction phase interval can facilitate the determination of the appropriate phase so that no artifacts are found due to errors in selecting the reconstruction phase interval, because in patients with atrial fibrillation, wave irregularities will result in differences in location between phase intervals. Conclusions:The use of pitch 0.2 aims to obtain a wider range of ECG RR intervals, thus minimizing the occurrence of interpolation artifacts in unstable patient heart rates. The use of calcium scorring reconstruction phase interval results as a guideline for setting the reconstruction phase interval in contrast scanning can facilitate the placement of appropriate and precise interval locations, so that no artifacts are found.