My turn now.
So it is Desktop (DT) form factor, very bad, lets go through your answers.
2. Let go to this thread and investigate, shall we?
I own the optiplex 745 desktop version (the version before the minitower)
That poor guy stated that he doesn't have Mini Tower, but the next to it (look at my picture), which is DT form factor.
And now look for the BEST SOLUTION
I have installed standard ATX PSUs into similar Dells, including an Optiplex 745 MT
This is not correct answer, because
OP has DT not
MT version. Best Solution is selected by ErVivek, which is, as I been told in the past, is some kind of automated system designed to find solutions, sometimes it works, sometimes it doesn't.
So, let me show you my point.
Lets look at your choice PSU
Dimensions 5.9" x 5.5" x 3.4"
Now let see the outside dimensions of Optiplex 745 DT version I will place measurements in correspondence to Seasonic dimensions
13.9" x 4.5" x 15.7" source
https://www.dell.com/downloads/global/products/optix/en/opti_745techspecs.pdf
Now lets actually open side panel and look inside, shall we?
So, Power Supply upgrade suggestion is incorrect, agreed? However, DT version has 280 watt PSU, which is more than enough for this MSI card with TDP of 60 watt or so. That card confirmed to work in Dell with 240 watt PSU.
5. SOCKET 775 WILL TAKE A Q6600
No questions, it will, but if MatthewMcLaughlin has Aluminum heatsink, his Q6600 would not last long enough to enjoy it, heat will cook it and might even take this MSI card with it, since it is very air tight PC case.
So, simple suggestion - Q6600 will fit - is not a good solution.
So best solution is half baked, I would say. MatthewMcLaughlin please do not buy new PSU or you will have nice looking paper weight.
Coming back to CPU heatsink. First, it is proprietary, so no aftermarket solutions are applicable here.
Aluminum on the left and Copper on the right, which one you have?
All Dell Optiplex QUADs have copper heatsink.
Your actual heatsink might look a bit different, but the idea is the same, just look for yellow parts inside the heatsink with a flash light, if you see vertical heating pipes - you have a copper.
If you have have Aluminum, well, it has to be upgraded to Optiplex 745 DT specific copper model, I am sure corndog1836 can find the proper one model number.
I am out.