Acute chest pain in emergency room. Preliminary findings with 40-64-slice CT ECG-gated of the whole chest.
ECG-gated MDCT of the entire chest represents the latest technical advance in the diagnostic work-up of atypical chest pain. The authors report their preliminary experience with the use of 40 and 64-slice CT in the emergency room and recommend to study only patients with moderate likelihood of coronary artery disease. ECG-gated MDCT of the entire chest will be preferentially performed on 64-slice MDCT rather than 40-slice MDCT because it enable to reduce the scan time (18 seconds versus 28 seconds acquisition time), the volume of contrast medium (82 mL + 15 mL versus 97 mL + 15 mL of highly concentrated contrast agent for a patient of 70 kgs) and radiation exposure (17 mSv versus 19 mSv). Approximately 1500 to 2000 of images are produced and need to be analysed on a dedicated workstation by a radiologist expert in cardiac and thoracic disorders. At the present time, only a few studies exist in the literature showing some promising results but further large clinical studies are needed before to implement such sophisticated protocol in emergency room.
Coche
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Department of Medical Imaging, Cliniques Universitaires St-Luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium. coche@rdgn.ucl.ac.be
D000208:Acute Disease; D002637:Chest Pain / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D006801:Humans; D018579:Patient Selection; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media