TY - JOUR
T1 - MDCT angiography of acute chest pain
T2 - Evaluation of ECG-gated and nongated techniques
AU - Raptopoulos, Vassilios D.
AU - Boiselle, Phillip B.
AU - Michailidis, Nikolaos
AU - Handwerker, Jason
AU - Sabir, Adeel
AU - Edlow, Jonathan A.
AU - Pedrosa, Ivan
AU - Kruskal, Jonathan B.
PY - 2006/6
Y1 - 2006/6
N2 - OBJECTIVE. The objective of our study was to compare MDCT angiography protocols used in patients with acute chest pain caused by vascular, nonvascular, and cardiac abnormalities. SUBJECTS AND METHODS. In four groups of 20 patients with chest pain each, four MDCT protocols were used based on monitoring vascular attenuation: pulmonary embolism (150 H at pulmonary artery), aortic dissection (200 H at aortic arch), chest pain (200 H at pulmonary artery), and chest pain with ECG gating (150 H at pulmonary artery). Vascular enhancement was assessed by attenuation measurements taken from locations in the pulmonary artery (n = 3) and thoracic aorta (n = 4). The appearance of the coronary artery in regard to opacification and motion was assessed on a scale of 1 to 5 (best). RESULTS. The mean pulmonary artery and aorta attenuation (372 H and 352 H, respectively) was significantly higher (p < 0.005, Student's t test) and the number of vessel attenuation points measuring less than 200 H (1/140) was significantly smaller (p < 0.001, chi-square test) in the chest pain compared with the dissection (318 H, 310 H; 16/140), gated chest pain (304 H, 286 H; 17/14), and pulmonary embolism (302 H, 220 H; 28/140) groups. The median coronary artery visualization score was 4; the proximal regions received a significantly (p < 0.005, Mann-Whitney test) higher grade compared with the middle and distal regions (medians, 5, 4, and 2, respectively). Artifacts were noted on the gated scans. CONCLUSION. The chest pain protocol can be used to assess both the pulmonary arteries and the thoracic aorta, whereas the ECG-gating protocol appears to be a promising adjunct for a comprehensive single chest pain protocol.
AB - OBJECTIVE. The objective of our study was to compare MDCT angiography protocols used in patients with acute chest pain caused by vascular, nonvascular, and cardiac abnormalities. SUBJECTS AND METHODS. In four groups of 20 patients with chest pain each, four MDCT protocols were used based on monitoring vascular attenuation: pulmonary embolism (150 H at pulmonary artery), aortic dissection (200 H at aortic arch), chest pain (200 H at pulmonary artery), and chest pain with ECG gating (150 H at pulmonary artery). Vascular enhancement was assessed by attenuation measurements taken from locations in the pulmonary artery (n = 3) and thoracic aorta (n = 4). The appearance of the coronary artery in regard to opacification and motion was assessed on a scale of 1 to 5 (best). RESULTS. The mean pulmonary artery and aorta attenuation (372 H and 352 H, respectively) was significantly higher (p < 0.005, Student's t test) and the number of vessel attenuation points measuring less than 200 H (1/140) was significantly smaller (p < 0.001, chi-square test) in the chest pain compared with the dissection (318 H, 310 H; 16/140), gated chest pain (304 H, 286 H; 17/14), and pulmonary embolism (302 H, 220 H; 28/140) groups. The median coronary artery visualization score was 4; the proximal regions received a significantly (p < 0.005, Mann-Whitney test) higher grade compared with the middle and distal regions (medians, 5, 4, and 2, respectively). Artifacts were noted on the gated scans. CONCLUSION. The chest pain protocol can be used to assess both the pulmonary arteries and the thoracic aorta, whereas the ECG-gating protocol appears to be a promising adjunct for a comprehensive single chest pain protocol.
KW - Aorta
KW - Aortic dissection
KW - CT coronary arteriography
KW - Cardiovascular imaging
KW - Coronary artery disease
KW - Emergency radiology
KW - MDCT angiography technique
KW - Pulmonary embolism
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U2 - 10.2214/AJR.04.1882
DO - 10.2214/AJR.04.1882
M3 - Article
C2 - 16714608
AN - SCOPUS:33745532499
SN - 0361-803X
VL - 186
SP - S346-S356
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 6 SUPPL. A
ER -