title: Limiting scan range of cardiac CT and the chance of missed acute aortic syndrome.
abstract: OBJECTIVE
  Recently, dedicated cardiac computed tomography (CT) has been performed to rule out acute coronary syndrome in patients with chest pain equivalents. However, acute aortic syndrome (AAS) could mimic acute coronary syndrome. We investigated the reliability of CT with a limited scan range for the detection of AAS.
  
  
  METHODS
  Patients older than 18 years with a diagnosis of AAS were included for a 10-year period. We reviewed all patients' electronic medical record and cardiac CT scan images. The AAS lesions outside of the upper or lower margin of the cardiac CT scan range were measured. Other abnormalities defined as indirect evidence of AAS such as pericardial effusion were also collected.
  
  
  RESULTS
  Of a total of 309 cases, 6 (1.9%; 95% confidence interval, 0.71-4.17) patients had aortic lesions outside of the cardiac CT scan range. One patient had an aortic lesion above the cardiac CT scan range, and 5 patients had aortic lesions below the cardiac CT scan range.
  
  
  CONCLUSIONS
  Aortic lesions outside of the cardiac CT scan range were not rare. Therefore, using a cardiac CT might not guarantee ruling out AAS completely.
authors: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors: Jongdae
authors: J
authors: Park
authors: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors: Joonghee
authors: J
authors: Kim
authors: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea. Electronic address: dremkks@snubh.org.
authors: Kyuseok
authors: K
authors: Kim
mesh_terms: D000208:Acute Disease; D001011:Aorta / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D001021:Aortic Valve / Q000000981:diagnostic imaging; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods