[ECG-gated chest CT angiography: value for atypical chest pain evaluation].
OBJECTIVE
The aim of this study was to evaluate ECG-gated whole chest CTA as a routine triage tool for patients with acute chest pain.


METHODS
Whole chest CTA with retrospective ECG-gating was performed in 30 patients with acute atypical chest pain. The ten main segments of the coronary arteries, the pulmonary arteries, the aorta, and the myocardium (function, morphology) were independently analyzed by a resident and two senior radiologists. The inter-observer agreement between resident and senior radiologists was calculated. A final diagnosis was determined by consensus.


RESULTS
Thirty patients were included. The coronary artery segments, myocardium and pulmonary arteries were considered analyzable in 84%, 90% and 97% of cases respectively. A final diagnosis for the cause of pain was retained in 19 patients: significant coronary artery stenosis (5), pulmonary embolus (5), aortic dissection (1), hypokinetic cardiomyopathy (2), lung parenchymal abnormalities (5), and hiatus hernia (1). Inter-observer agreement ranged from 0.76 to 1 between senior radiologists and from 0.76 to 1 between resident and senior radiologists. The average time of image interpretation ranged from 14 to 15 minutes.


CONCLUSIONS
ECG-gated whole chest CT angiography appears as a promising tool for the evaluation of acute chest pain. Combined evaluation of appearance and function of the myocardium can reveal additional interesting information.
Bierry
G
G
Service de Radiologie B, Hôpitaux Universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex.
Roy
C
C
Buy
X
X
Kellner
F
F
Jlassi
H
H
Gangi
A
A
D000208:Acute Disease; D000368:Aged; D000792:Angiography / Q000379:methods*; D055424:Cardiac-Gated Imaging Techniques; D002637:Chest Pain / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000150:complications; D003627:Data Interpretation, Statistical; D004562:Electrocardiography; D004630:Emergencies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D018579:Patient Selection; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000150:complications; D014057:Tomography, X-Ray Computed / Q000379:methods*