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Initial experience with a chest pain protocol using 320-slice volume MDCT

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Abstract

We sought to determine the feasibility and image quality of 320-slice volume computed tomography (CT) angiography for the evaluation of patients with acute chest pain. Thirty consecutive patients (11 female, 19 male, mean age 63.2 ± 14.2 years) with noncritical, acute chest pain underwent 320-slice CT using a protocol consisting of a nonspiral, nongated CT of the entire chest, followed by a nonspiral, electrocardiography-gated CT study of the heart. Data were acquired following a biphasic intravenous injection of 90 ml iodinated contrast agent. Vessel attenuation values of different thoracic vascular territories were recorded, and image quality scored on a five-point scale by two readers. Mean attenuation was 467 ± 69 HU in the ascending aorta, 334 ± 52 HU in the aortic arch, 455 ± 71 HU in the descending aorta, 492 ± 94 HU in the pulmonary trunk, and 416 ± 63 HU and 436 ± 62 HU in the right and left coronary artery, respectively. Radiation exposure estimates ranged between 7 and 14 mSv. The CT protocol investigated enabled imaging of the thoracic aorta, coronary and pulmonary arteries with an excellent diagnostic quality for chest pain triage in all patients. This result was achieved with less contrast material and reduced radiation exposure compared with previously investigated imaging protocols.

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References

  1. Johnson TR, Nikolaou K, Wintersperger BJ et al (2007) ECG-gated 64-MDCT angiography in the differential diagnosis of acute chest pain. AJR Am J Roentgenol 188:76–82

    Article  PubMed  Google Scholar 

  2. Hoffmann U, Nagumey JT, Moselewski F et al (2006) Coronary multidetector computed tomography in the assessment of patients with acute chest pain. Circulation 114:2251–2260

    Article  PubMed  Google Scholar 

  3. Achenbach S, Ropers D, Kuettner A et al (2006) Contrast-enhanced coronary artery visualization by dual-source computed tomography—initial experience. Eur J Radiol 57:331–335

    Article  PubMed  Google Scholar 

  4. Scheffel H, Alkadhi H, Plass A et al (2006) Accuracy of dual-source CT coronary angiography: First experience in a high pre-test probability population without heart rate control. Eur Radiol 16:2739–2747

    Article  PubMed  Google Scholar 

  5. Sun Z, Jiang W (2006) Diagnostic value of multislice computed tomography angiography in coronary artery disease: a meta-analysis. Eur J Radiol 60:279–286

    Article  PubMed  Google Scholar 

  6. Schaefer-Prokop C, Prokop M (2005) MDCT for the diagnosis of acute pulmonary embolism. Eur Radiol 15(Suppl 4):D37–D41

    PubMed  Google Scholar 

  7. Quiroz R, Kucher N, Zou KH et al (2005) Clinical validity of a negative computed tomography scan in patients with suspected pulmonary embolism: a systematic review. JAMA 293:2012–2017

    Article  PubMed  CAS  Google Scholar 

  8. Willoteaux S, Lions C, Gaxotte V et al (2004) Imaging of aortic dissection by helical computed tomography (CT). Eur Radiol 14:1999–2008

    Article  PubMed  Google Scholar 

  9. Alkadhi H, Wildermuth S, Desbiolles L et al (2004) Vascular emergencies of the thorax after blunt and iatrogenic trauma: multi-detector row CT and three-dimensional imaging. Radiographics 24:1239–1255

    Article  PubMed  Google Scholar 

  10. Litmanovitch D, Zamboni GA, Hauser TH et al (2008) ECG-gated chest CT angiography with 64-MDCT and tri-phasic IV contrast administration regimen in patients with acute non-specific chest pain. Eur Radiol 18:308–317

    Article  PubMed  Google Scholar 

  11. Schussler JM, Smith ER (2007) Sixty-four-slice computed tomographic coronary angiography: will the “triple rule out” change chest pain evaluation in the ED? Am J Emerg Med 25:367–375

    Article  PubMed  Google Scholar 

  12. Lembcke A, Wiese TH, Schnorr J et al (2004) Image quality of noninvasive coronary angiography using multislice spiral computed tomography and electron-beam computed tomography: intraindividual comparison in an animal model. Invest Radiol 39:357–364

    Article  PubMed  Google Scholar 

  13. Einstein AJ, Henzlova MJ, Rajagopalan S (2007) Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 298:317–323

    Article  PubMed  CAS  Google Scholar 

  14. Johnson TR, Nikolaou K, Becker A et al (2008) Dual source CT for chest pain assessment. Eur Radiol 18:773–780

    Article  PubMed  Google Scholar 

  15. Gallagher MJ, Raff GL (2008) Use of multislice CT for the evaluation of emergency room patients with chest pain: the so-called triple rule-out. Catheter Cardiovasc Interv 71:92–99

    Article  PubMed  Google Scholar 

  16. Haidary A, Bis K, Vrachiolitis T et al (2007) Enhancement performance of a 64-slice triple rule-out protocol vs 16-slice and 10-slice multidetector CT-angiography protocols for evaluation of aortic and pulmonary vasculature. J Comput Assist Tomogr 31:917–923

    Article  PubMed  Google Scholar 

  17. Schertler T, Scheffel H, Frauenfelder T et al (2007) Dual-source computed tomography in patients with acute chest pain: feasibility and image quality. Eur Radiol 17:3179–3188

    Article  PubMed  Google Scholar 

  18. Mori S, Endo M, Obata T et al (2005) Clinical potentials of the prototype 256-detector row CT-scanner. Acad Radiol 12:148–154

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institut für Radiologie, Charité Campus Mitte, Charité—Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Germany

    Patrick A. Hein, Valentina C. Romano, Alexander Lembcke, Juliane May & Patrik Rogalla

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  1. Patrick A. Hein
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  2. Valentina C. Romano
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  3. Alexander Lembcke
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  4. Juliane May
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  5. Patrik Rogalla
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Correspondence to Patrick A. Hein.

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Hein, P.A., Romano, V.C., Lembcke, A. et al. Initial experience with a chest pain protocol using 320-slice volume MDCT. Eur Radiol 19, 1148–1155 (2009). https://doi.org/10.1007/s00330-008-1255-8

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  • DOI: https://doi.org/10.1007/s00330-008-1255-8

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