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CT Cardiac Bypass Graft

 

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Report
Procedure
[ ______ ]
Clinical information
Age [{positiveInteger} years]
Gender
Female
Male
Risk factors [ ______ ]
Hyperlipidemia [ ______ ]
Hypertension [ ______ ]
Diabetes [ ______ ]
Autoimmune disease [ ______ ]
Prior MI [ ______ ]
Prior stroke [ ______ ]
Smoking [ ______ ]
Heart disease [ ______ ]
[ ______ ]
Comparison
None [ ______ ]
[ ______ ]
Findings
Examination quality
//is limited by [poor venous opacification; misregistration artifacts; patient motion; metal artifact; arrhythmia]
Excellent
Good
Fair
Poor
Nondiagnostic
Limitation [ ______ ]
Poor venous opacification [ ______ ]
Misregistration artifacts [ ______ ]
Patient motion [ ______ ]
Calcium blooming artifacts [ ______ ]
Metal artifact [ ______ ]
Arrhythmia [ ______ ]
Cardiac findings [ ______ ]
Coronary artery system
Right-dominant [ ______ ] //Default
Left-dominant [ ______ ]
Co-dominant [ ______ ]
Left main coronary artery
//LCA
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Left anterior descending artery
//Left anterior descending (LAD) coronary artery
Normal [ ______ ]
Proximal LAD
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Mid LAD
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Distal LAD
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Diagonal branch 1 //D1
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Diagonal branch 2 //D2
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Diagonal branch 3 //D3
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Myocardial bridge
None
Short [ ______ ]
Long [ ______ ]
Superficial [ ______ ]
Deep [ ______ ]
Segment
Proximal [ ______ ]
Mid [ ______ ]
Distal [ ______ ]
[ ______ ]
Ramus intermedius branch
Absent
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Left circumflex artery
//Left circumflex (LCX) coronary artery
Normal [ ______ ]
Proximal LCX
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Mid LCX
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Distal LCX
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Left posterior descending artery //LPDA
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Left posterolateral branches
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Obtuse marginal branch 1 //OM1
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Obtuse marginal branch 2 //OM2
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Obtuse marginal branch 3 //OM3
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Right coronary artery
Normal [ ______ ]
Proximal RCA
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Mid RCA
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Distal RCA
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Right posterior descending artery
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Right posterolateral branches
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
Acute marginal branches
Normal [ ______ ]
Anomaly //Anomalous origin or course of artery
None
[ ______ ]
Plaque
None [ ______ ]
Noncalcified [ ______ ]
Mixed [ ______ ]
Calcified [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Stents
None
Number of stents [{positiveInteger} ]
0+ Stent [ ______ ]
Size [ ______ ]
Type [ ______ ]
Segmental location
Proximal
Mid
Distal
[ ______ ]
Relation to the adjacent branch-vessel ostium [ ______ ]
Lumen
Patent [ ______ ]
Stenotic [ ______ ]
Occluded [ ______ ]
Nonevaluable [ ______ ]
Stent fracture
None
[ ______ ]
In-stent calcification
None
[ ______ ]
[ ______ ]
1+ Bypass graft
Type //Engrafted vessel
LIMA
RIMA
Saphenous vein
Radial artery
Gastroepiploic artery
Insertion
LAD
Proximal
Mid
Distal
[ ______ ]
D1
Proximal
Mid
Distal
[ ______ ]
D2
Proximal
Mid
Distal
[ ______ ]
D3
Proximal
Mid
Distal
[ ______ ]
LCX
Proximal
Mid
Distal
[ ______ ]
OM1
Proximal
Mid
Distal
[ ______ ]
OM2
Proximal
Mid
Distal
[ ______ ]
OM3
Proximal
Mid
Distal
[ ______ ]
RCA
Proximal
Mid
Distal
[ ______ ]
PDA
Proximal
Mid
Distal
[ ______ ]
Posterolateral artery
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Relationship to sternum
Below sternal notch [{decimal} ]
Well separated [ ______ ]
Abutment [ ______ ]
Stenosis
None [ ______ ] //No stenosis
Mild [ ______ ] //1-49% stenosis
Moderate [ ______ ] //50-70% stenosis
Severe [ ______ ] // > 70% stenosis
Occlusion [ ______ ]
Nonevaluable [ ______ ]
Location
Proximal
Mid
Distal
[ ______ ]
[ ______ ]
Cardiac morphology
Right atrium
Normal [ ______ ] //Default
Dilated [ ______ ]
[ ______ ]
Right ventricle
Normal [ ______ ] //Default
Dilated [ ______ ]
Hypertrophic [ ______ ]
[ ______ ]
Left atrium
Normal [ ______ ] //Default
Dilated [ ______ ]
[ ______ ]
Left ventricle
Normal [ ______ ] //Default
Dilated [ ______ ]
Hypertrophic [ ______ ]
[ ______ ]
Septal defect
None
Atrial septal defect [ ______ ]
Ventricular septal defect [ ______ ]
Patent foramen ovale [ ______ ]
[ ______ ]
Pericardium
Normal [ ______ ] //Default
Thickening
None
[ ______ ]
Calcification
None
[ ______ ]
Pericardial effusion
None [ ______ ] //Default
Small [ ______ ]
Moderate [ ______ ]
Large [ ______ ]
Aortic valve
Not evaluated
Normal [ ______ ]
Tricuspid [ ______ ] //Default
Congenitally bicuspid [ ______ ]
Functionally bicuspid [ ______ ]
[ ______ ]
Leaflets //Valve leaflet morphology and motion
Normal [ ______ ] //Default
Thickened [ ______ ]
Calcified [ ______ ]
Function
//Function is reported only if retrospective gating was used
Not evaluated
Normal
Motion abnormality [ ______ ]
Stenosis [ ______ ]
Regurgitation [ ______ ]
[ ______ ]
Mitral valve
Not evaluated
Normal [ ______ ]
Leaflets //Valve leaflet morphology and motion
Normal [ ______ ] //Default
Thickened [ ______ ]
Calcified [ ______ ]
Leaflet motion
Not evaluated
Normal [ ______ ]
Prolapse
None
Anterior leaflet
Posterior leaflet
Flail valve
None
Anterior leaflet
Posterior leaflet
Function
//Function is reported only if retrospective gating was used
Not evaluated
Normal
Motion abnormality [ ______ ]
Stenosis [ ______ ]
Regurgitation [ ______ ]
[ ______ ]
Cardiac function
Not evaluated
Normal [ ______ ]
Ejection fraction [{nonNegativeInteger} %]
End-diastolic volume [{decimal} mL]
End-systolic volume [{decimal} mL]
Regional wall motion abnormality
None
Anterior
Normal [ ______ ]
Hypokinesia [ ______ ]
Akinesia [ ______ ]
Dyskinesia [ ______ ]
Anterolateral
Normal [ ______ ]
Hypokinesia [ ______ ]
Akinesia [ ______ ]
Dyskinesia [ ______ ]
Anteroseptal
Normal [ ______ ]
Hypokinesia [ ______ ]
Akinesia [ ______ ]
Dyskinesia [ ______ ]
Lateral
Normal [ ______ ]
Hypokinesia [ ______ ]
Akinesia [ ______ ]
Dyskinesia [ ______ ]
Inferolateral
Normal [ ______ ]
Hypokinesia [ ______ ]
Akinesia [ ______ ]
Dyskinesia [ ______ ]
Inferoseptal
Normal [ ______ ]
Hypokinesia [ ______ ]
Akinesia [ ______ ]
Dyskinesia [ ______ ]
Septal
Normal [ ______ ]
Hypokinesia [ ______ ]
Akinesia [ ______ ]
Dyskinesia [ ______ ]
Inferior
Normal [ ______ ]
Hypokinesia [ ______ ]
Akinesia [ ______ ]
Dyskinesia [ ______ ]
[ ______ ]
Cardiac devices [ ______ ]
Extracardiac findings
None
Pulmonary arteries
Normal [ ______ ]
Diameter
Normal [ ______ ]
[ ______ ]
Pulmonary emboli
None [ ______ ]
Lobar [ ______ ]
Segmental [ ______ ]
Subsegmental [ ______ ]
[ ______ ]
Thoracic aorta
Normal [ ______ ]
[ ______ ]
[ ______ ]
Impression
[ ______ ]
Recommendation [ ______ ]