2026 UPDATED QUESTIONS DOWNLOAD
EACVI Cardiac Computed Tomography (CCT) Actual Exam Prep 2026 | 350+ Q&A with
Rationales | Level 1, 2, & 3 Certification Review
Master the 2026/2027 EACVI Cardiac CT Certification Exam with this comprehensive bank of 350+
high-yield practice questions designed to mirror the official European syllabus. Each question features
a detailed, italicized rationale covering essential domains such as Agatston calcium scoring,
prospective vs. retrospective gating, coronary anatomy, and TAVI/TAVR planning. This
professional study guide provides the technical and clinical expertise needed to manage radiation
safety (ALARA), contrast-induced nephropathy (CIN), and complex imaging artifacts for a
guaranteed first-time pass.
1. Which of the following defines the "Temporal Resolution" of a CT scanner?
A. The smallest distance between two distinguishable objects.
B. The time required to acquire data for a single image reconstruction.
C. The total time the patient spends inside the gantry.
D. The speed of the contrast injection.
Rationale: B. Temporal resolution is the "shutter speed" of the CT; it is the time needed to
acquire enough data to freeze cardiac motion, typically half the gantry rotation time in single-
source scanners.
2. Prospective ECG-triggering (Step-and-Shoot) is characterized by:
A. Continuous X-ray exposure throughout the R-R interval.
B. Higher radiation dose than retrospective gating.
C. X-ray tube activation only during a specific window of the cardiac cycle.
D. The ability to reconstruct images at any phase of the heart cycle.
Rationale: C. Prospective triggering turns the X-ray on only during a predefined window
(usually mid-diastole), significantly reducing radiation compared to retrospective gating.
3. What is the primary purpose of administering sublingual Nitroglycerin before a
CCTA?
A. To lower the heart rate below 60 bpm.
B. To prevent contrast-induced nephropathy.
C. To induce maximal coronary vasodilation and improve stenosis assessment.
D. To reduce patient anxiety.
Rationale: C. Nitrates dilate the coronary arteries, allowing for better visualization of small
branches and more accurate assessment of the vessel lumen.
4. A "Blooming Artifact" on Cardiac CT is most often caused by:
A. Rapid patient breathing.
B. High-density structures like heavy calcification or metal stents.
C. Low contrast concentration in the aorta.
, 2026 UPDATED QUESTIONS DOWNLOAD
D. Slow gantry rotation speed.
Rationale: B. Blooming occurs when highly dense objects (calcium/metal) appear larger than
they are, often leading to overestimation of the degree of stenosis.
5. In a "Right-Dominant" coronary system, the Posterior Descending Artery (PDA) arises
from:
A. The Left Circumflex (LCx).
B. The Left Anterior Descending (LAD).
C. The Right Coronary Artery (RCA).
D. The Left Main.
Rationale: C. Dominance is defined by which artery gives rise to the PDA and posterolateral
branches. In ~85% of people, this is the RCA.
6. Which of the following is a contraindication for the administration of Beta-blockers
prior to CT?
A. Hypertension.
B. Sinus Tachycardia.
C. Second or Third-degree AV Block.
D. Anxiety.
Rationale: C. Beta-blockers can dangerously slow conduction in patients with advanced heart
blocks.
7. "Pitch" in helical/spiral CT is defined as:
A. The speed of the X-ray tube rotation.
B. Table feed per rotation divided by the total collimation width.
C. The thickness of the contrast bolus.
D. The angle of the gantry tilt.
Rationale: B. Pitch > 1 means there are gaps in the helix; Pitch < 1 indicates overlapping data,
which is standard for retrospective cardiac imaging.
8. An Agatston score of 150 is categorized as:
A. Minimal calcification.
B. Mild calcification.
C. Moderate calcification.
D. Extensive calcification.
Rationale: C. Agatston scoring: 0=None, 1-10=Minimal, 11-100=Mild, 101-400=Moderate,
>400=Severe.
9. Which anatomical structure is located in the anterior interventricular sulcus?
A. Left Circumflex (LCx).
B. Right Coronary Artery (RCA).
C. Left Anterior Descending (LAD).
D. Coronary Sinus.
Rationale: C. The LAD travels in the anterior interventricular groove toward the apex.
, 2026 UPDATED QUESTIONS DOWNLOAD
10. What is the Hounsfield Unit (HU) of pure water?
A. -1000.
B. 0.
C. +100.
D. +1000.
Rationale: B. Water is the reference point for 0 HU; Air is -1000 and Bone is >+400.
11. Which artifact is caused by the heart moving during the "Step-and-Shoot"
acquisition?
A. Ring artifact.
B. Misregistration/Step-artifact.
C. Beam hardening.
D. Photon starvation.
Rationale: B. If the heart position varies between table steps (due to an extra beat or rhythm
change), the vessels will appear "broken" or misaligned between slices.
12. The "Sinus of Valsalva" is found in which structure?
A. Pulmonary Artery.
B. Right Atrium.
C. Aortic Root.
D. Left Ventricle.
Rationale: C. The three sinuses (Right, Left, Non-coronary) are the anatomical dilatations at
the base of the aorta.
13. Which medication is first-line for heart rate control in CCT?
A. Amlodipine.
B. Metoprolol.
C. Lisinopril.
D. Furosemide.
Rationale: B. Beta-blockers like Metoprolol are used to achieve a steady heart rate, ideally
below 60-65 bpm.
14. "Beam Hardening" typically manifests on a CT image as:
A. Bright white spots.
B. Dark streaks or shadows between dense objects.
C. Circular lines around the center.
D. Blurring of the vessel edges.
Rationale: B. As the X-ray beam passes through dense objects, lower-energy photons are
absorbed, leaving "harder" rays that create dark streak artifacts.
15. The "Effective Dose" of radiation is measured in:
A. Hounsfield Units (HU).
B. Millisieverts (mSv).
C. Millimeters (mm).
, 2026 UPDATED QUESTIONS DOWNLOAD
D. Milliamperes (mA).
Rationale: B. mSv is the unit used to estimate the biological risk of radiation.
16. Which "CAD-RADS" score represents a totally normal coronary scan with no
plaque?
A. CAD-RADS 0.
B. CAD-RADS 1.
C. CAD-RADS 3.
Rationale: A. CAD-RADS 0 indicates the complete absence of CAD.
17. "Dual-Source CT" (DSCT) improves temporal resolution by:
A. Using two contrast injectors.
B. Using two X-ray tubes and detectors at 90-degree angles.
C. Rotating the gantry twice as fast.
D. Increasing the slice thickness.
Rationale: B. DSCT allows for data acquisition in roughly one-quarter of a rotation, significantly
"freezing" motion.
18. Which coronary artery supplies the SA node in the majority (~60%) of the
population?
A. Left Anterior Descending (LAD).
B. Right Coronary Artery (RCA).
C. Left Circumflex (LCx).
D. Diagonal branch.
Rationale: B. The SA nodal artery most commonly arises from the proximal RCA.
19. A "Myocardial Bridge" is best defined as:
A. A bypass graft between two vessels.
B. A segment of a coronary artery that travels through the myocardium instead of the
epicardium.
C. A calcified plaque blocking the vessel.
D. A congenital hole in the heart wall.
Rationale: B. This can cause the vessel to be compressed during systole.
20. "Bolus Tracking" is a technique used to:
A. Calculate the patient's ejection fraction.
B. Automatically trigger the scan when contrast reaches a set HU threshold in the aorta.
C. Measure the speed of blood flow in the veins.
D. Reduce the heart rate.
Rationale: B. It ensures the scan starts exactly when contrast opacification is at its peak.
21. Which CT parameter primarily controls the "Image Noise"?
A. Gantry tilt.
B. Tube current (mAs).
C. Table speed.
EACVI Cardiac Computed Tomography (CCT) Actual Exam Prep 2026 | 350+ Q&A with
Rationales | Level 1, 2, & 3 Certification Review
Master the 2026/2027 EACVI Cardiac CT Certification Exam with this comprehensive bank of 350+
high-yield practice questions designed to mirror the official European syllabus. Each question features
a detailed, italicized rationale covering essential domains such as Agatston calcium scoring,
prospective vs. retrospective gating, coronary anatomy, and TAVI/TAVR planning. This
professional study guide provides the technical and clinical expertise needed to manage radiation
safety (ALARA), contrast-induced nephropathy (CIN), and complex imaging artifacts for a
guaranteed first-time pass.
1. Which of the following defines the "Temporal Resolution" of a CT scanner?
A. The smallest distance between two distinguishable objects.
B. The time required to acquire data for a single image reconstruction.
C. The total time the patient spends inside the gantry.
D. The speed of the contrast injection.
Rationale: B. Temporal resolution is the "shutter speed" of the CT; it is the time needed to
acquire enough data to freeze cardiac motion, typically half the gantry rotation time in single-
source scanners.
2. Prospective ECG-triggering (Step-and-Shoot) is characterized by:
A. Continuous X-ray exposure throughout the R-R interval.
B. Higher radiation dose than retrospective gating.
C. X-ray tube activation only during a specific window of the cardiac cycle.
D. The ability to reconstruct images at any phase of the heart cycle.
Rationale: C. Prospective triggering turns the X-ray on only during a predefined window
(usually mid-diastole), significantly reducing radiation compared to retrospective gating.
3. What is the primary purpose of administering sublingual Nitroglycerin before a
CCTA?
A. To lower the heart rate below 60 bpm.
B. To prevent contrast-induced nephropathy.
C. To induce maximal coronary vasodilation and improve stenosis assessment.
D. To reduce patient anxiety.
Rationale: C. Nitrates dilate the coronary arteries, allowing for better visualization of small
branches and more accurate assessment of the vessel lumen.
4. A "Blooming Artifact" on Cardiac CT is most often caused by:
A. Rapid patient breathing.
B. High-density structures like heavy calcification or metal stents.
C. Low contrast concentration in the aorta.
, 2026 UPDATED QUESTIONS DOWNLOAD
D. Slow gantry rotation speed.
Rationale: B. Blooming occurs when highly dense objects (calcium/metal) appear larger than
they are, often leading to overestimation of the degree of stenosis.
5. In a "Right-Dominant" coronary system, the Posterior Descending Artery (PDA) arises
from:
A. The Left Circumflex (LCx).
B. The Left Anterior Descending (LAD).
C. The Right Coronary Artery (RCA).
D. The Left Main.
Rationale: C. Dominance is defined by which artery gives rise to the PDA and posterolateral
branches. In ~85% of people, this is the RCA.
6. Which of the following is a contraindication for the administration of Beta-blockers
prior to CT?
A. Hypertension.
B. Sinus Tachycardia.
C. Second or Third-degree AV Block.
D. Anxiety.
Rationale: C. Beta-blockers can dangerously slow conduction in patients with advanced heart
blocks.
7. "Pitch" in helical/spiral CT is defined as:
A. The speed of the X-ray tube rotation.
B. Table feed per rotation divided by the total collimation width.
C. The thickness of the contrast bolus.
D. The angle of the gantry tilt.
Rationale: B. Pitch > 1 means there are gaps in the helix; Pitch < 1 indicates overlapping data,
which is standard for retrospective cardiac imaging.
8. An Agatston score of 150 is categorized as:
A. Minimal calcification.
B. Mild calcification.
C. Moderate calcification.
D. Extensive calcification.
Rationale: C. Agatston scoring: 0=None, 1-10=Minimal, 11-100=Mild, 101-400=Moderate,
>400=Severe.
9. Which anatomical structure is located in the anterior interventricular sulcus?
A. Left Circumflex (LCx).
B. Right Coronary Artery (RCA).
C. Left Anterior Descending (LAD).
D. Coronary Sinus.
Rationale: C. The LAD travels in the anterior interventricular groove toward the apex.
, 2026 UPDATED QUESTIONS DOWNLOAD
10. What is the Hounsfield Unit (HU) of pure water?
A. -1000.
B. 0.
C. +100.
D. +1000.
Rationale: B. Water is the reference point for 0 HU; Air is -1000 and Bone is >+400.
11. Which artifact is caused by the heart moving during the "Step-and-Shoot"
acquisition?
A. Ring artifact.
B. Misregistration/Step-artifact.
C. Beam hardening.
D. Photon starvation.
Rationale: B. If the heart position varies between table steps (due to an extra beat or rhythm
change), the vessels will appear "broken" or misaligned between slices.
12. The "Sinus of Valsalva" is found in which structure?
A. Pulmonary Artery.
B. Right Atrium.
C. Aortic Root.
D. Left Ventricle.
Rationale: C. The three sinuses (Right, Left, Non-coronary) are the anatomical dilatations at
the base of the aorta.
13. Which medication is first-line for heart rate control in CCT?
A. Amlodipine.
B. Metoprolol.
C. Lisinopril.
D. Furosemide.
Rationale: B. Beta-blockers like Metoprolol are used to achieve a steady heart rate, ideally
below 60-65 bpm.
14. "Beam Hardening" typically manifests on a CT image as:
A. Bright white spots.
B. Dark streaks or shadows between dense objects.
C. Circular lines around the center.
D. Blurring of the vessel edges.
Rationale: B. As the X-ray beam passes through dense objects, lower-energy photons are
absorbed, leaving "harder" rays that create dark streak artifacts.
15. The "Effective Dose" of radiation is measured in:
A. Hounsfield Units (HU).
B. Millisieverts (mSv).
C. Millimeters (mm).
, 2026 UPDATED QUESTIONS DOWNLOAD
D. Milliamperes (mA).
Rationale: B. mSv is the unit used to estimate the biological risk of radiation.
16. Which "CAD-RADS" score represents a totally normal coronary scan with no
plaque?
A. CAD-RADS 0.
B. CAD-RADS 1.
C. CAD-RADS 3.
Rationale: A. CAD-RADS 0 indicates the complete absence of CAD.
17. "Dual-Source CT" (DSCT) improves temporal resolution by:
A. Using two contrast injectors.
B. Using two X-ray tubes and detectors at 90-degree angles.
C. Rotating the gantry twice as fast.
D. Increasing the slice thickness.
Rationale: B. DSCT allows for data acquisition in roughly one-quarter of a rotation, significantly
"freezing" motion.
18. Which coronary artery supplies the SA node in the majority (~60%) of the
population?
A. Left Anterior Descending (LAD).
B. Right Coronary Artery (RCA).
C. Left Circumflex (LCx).
D. Diagonal branch.
Rationale: B. The SA nodal artery most commonly arises from the proximal RCA.
19. A "Myocardial Bridge" is best defined as:
A. A bypass graft between two vessels.
B. A segment of a coronary artery that travels through the myocardium instead of the
epicardium.
C. A calcified plaque blocking the vessel.
D. A congenital hole in the heart wall.
Rationale: B. This can cause the vessel to be compressed during systole.
20. "Bolus Tracking" is a technique used to:
A. Calculate the patient's ejection fraction.
B. Automatically trigger the scan when contrast reaches a set HU threshold in the aorta.
C. Measure the speed of blood flow in the veins.
D. Reduce the heart rate.
Rationale: B. It ensures the scan starts exactly when contrast opacification is at its peak.
21. Which CT parameter primarily controls the "Image Noise"?
A. Gantry tilt.
B. Tube current (mAs).
C. Table speed.
