MDCT angiography of acute chest pain

Evaluation of ECG-gated and nongated techniques

Vassilios D. Raptopoulos, Phillip B. Boiselle, Nikolaos Michailidis, Jason Handwerker, Adeel Sabir, Jonathan A. Edlow, Ivan Pedrosa, Jonathan B. Kruskal

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalAmerican Journal of Roentgenology
Volume186
Issue number6 SUPPL. A
DOIs
StatePublished - Jun 2006

Fingerprint

Acute Pain
Chest Pain
Angiography
Electrocardiography
Pulmonary Artery
Thoracic Aorta
Blood Vessels
Pulmonary Embolism
Dissection
Coronary Vessels
Chi-Square Distribution
Artifacts
Aorta
Students

Keywords

  • Aorta
  • Aortic dissection
  • Cardiovascular imaging
  • Coronary artery disease
  • CT coronary arteriography
  • Emergency radiology
  • MDCT angiography technique
  • Pulmonary embolism

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Raptopoulos, V. D., Boiselle, P. B., Michailidis, N., Handwerker, J., Sabir, A., Edlow, J. A., ... Kruskal, J. B. (2006). MDCT angiography of acute chest pain: Evaluation of ECG-gated and nongated techniques. American Journal of Roentgenology, 186(6 SUPPL. A). https://doi.org/10.2214/AJR.04.1882

MDCT angiography of acute chest pain : Evaluation of ECG-gated and nongated techniques. / Raptopoulos, Vassilios D.; Boiselle, Phillip B.; Michailidis, Nikolaos; Handwerker, Jason; Sabir, Adeel; Edlow, Jonathan A.; Pedrosa, Ivan; Kruskal, Jonathan B.

In: American Journal of Roentgenology, Vol. 186, No. 6 SUPPL. A, 06.2006.

Research output: Contribution to journalArticle

Raptopoulos, VD, Boiselle, PB, Michailidis, N, Handwerker, J, Sabir, A, Edlow, JA, Pedrosa, I & Kruskal, JB 2006, 'MDCT angiography of acute chest pain: Evaluation of ECG-gated and nongated techniques', American Journal of Roentgenology, vol. 186, no. 6 SUPPL. A. https://doi.org/10.2214/AJR.04.1882
Raptopoulos VD, Boiselle PB, Michailidis N, Handwerker J, Sabir A, Edlow JA et al. MDCT angiography of acute chest pain: Evaluation of ECG-gated and nongated techniques. American Journal of Roentgenology. 2006 Jun;186(6 SUPPL. A). https://doi.org/10.2214/AJR.04.1882
Raptopoulos, Vassilios D. ; Boiselle, Phillip B. ; Michailidis, Nikolaos ; Handwerker, Jason ; Sabir, Adeel ; Edlow, Jonathan A. ; Pedrosa, Ivan ; Kruskal, Jonathan B. / MDCT angiography of acute chest pain : Evaluation of ECG-gated and nongated techniques. In: American Journal of Roentgenology. 2006 ; Vol. 186, No. 6 SUPPL. A.
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abstract = "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.",
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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.

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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 - Cardiovascular imaging

KW - Coronary artery disease

KW - CT coronary arteriography

KW - Emergency radiology

KW - MDCT angiography technique

KW - Pulmonary embolism

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