Cardiac CT for acute chest pain in the emergency department: advantages of prospective triggering

被引:3
作者
Knowles, Negar G. [1 ]
Patel, Smita [1 ]
Kazerooni, Ella A. [1 ]
机构
[1] Univ Michigan Hlth Syst, Dept Radiol, Cardiovasc Ctr 5482, Ann Arbor, MI 48109 USA
关键词
Prospectively-triggered; Coronary CTA; Radiation exposure; Emergency department; Chest pain; MULTIDETECTOR COMPUTED-TOMOGRAPHY; INVASIVE CORONARY-ANGIOGRAPHY; ACUTE MYOCARDIAL-INFARCTION; IMAGE QUALITY; DIAGNOSTIC PERFORMANCE; RADIATION-EXPOSURE; ARTERY-DISEASE; 64-SECTION CT; SPIRAL CT; RISK;
D O I
10.1007/s10554-008-9419-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Coronary CT angiography (CCTA) is emerging as a powerful tool for the diagnosis and characterization of coronary artery disease. In the emergency department (ED) setting, the high negative predictive value of CCTA has been shown to reduce the length of stay and the cost of care in the evaluation of patients at low and intermediate risk for an acute coronary syndrome (ACS). In addition, CCTA and triple-rule-out protocol CT examinations which simultaneously evaluate the coronary arteries, aorta and pulmonary arteries, have the potential to diagnose not only significant atherosclerotic coronary artery disease (CAD) and coronary artery anomalies, but noncoronary etiologies of chest pain, including pulmonary embolism, aortic dissection, infection, pleural and pericardial disease. Caution has been raised about the widespread use of CCTA in this setting, particularly given the prevalence of repeat ED visits for chest pain, due to the radiation exposure associated with retrospectively-gated CCTA. However, the recent development of prospectively-triggered coronary artery CTA makes the ED evaluation possible with a substantially lower radiation exposure to the patient. Although most studies of CCTA to date are performed with retrospective ECG gating, early reports on prospectively triggered CCTA demonstrate equivalent image quality and accuracy when compared to studies acquired with retrospective ECG gating.
引用
收藏
页码:255 / 265
页数:11
相关论文
共 50 条
[31]   Cardiac Magnetic Resonance Imaging (CMRI) Applications in Patients with Chest Pain in the Emergency Department: A Narrative Review [J].
Zareiamand, Hossein ;
Darroudi, Amin ;
Mohammadi, Iraj ;
Moravvej, Seyed Vahid ;
Danaei, Saba ;
Alizadehsani, Roohallah .
DIAGNOSTICS, 2023, 13 (16)
[32]   Diagnostic performance and cost of CT angiography versus stress ECG - A randomized prospective study of suspected acute coronary syndrome chest pain in the emergency department (CT-COMPARE) [J].
Hamilton-Craig, Christian ;
Fifoot, Allison ;
Hansena, Mark ;
Pincus, Matthew ;
Chan, Jonathan ;
Walters, Darren L. ;
Branch, Kelley R. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2014, 177 (03) :867-873
[33]   Chest pain in the emergency department: From score to core-A prospective clinical study [J].
Jukneviciene, Renata ;
Juknevicius, Vytautas ;
Jasiunas, Eugenijus ;
Rasciute, Beatrice ;
Barysiene, Jurate ;
Mataciunas, Mindaugas ;
Vitkus, Dalius ;
Laucevicius, Aleksandras ;
Serpytis, Pranas .
MEDICINE, 2022, 101 (29) :E29579
[34]   Validation of the new Vancouver Chest Pain Rule in Asian chest pain patients presenting at the emergency department [J].
Ong, Marcus Eng Hock ;
Hao, Ying ;
Yap, Susan ;
Pek, Pin Pin ;
Chua, Terrance Siang Jin ;
Ng, Faith Suan Peng ;
Lim, Swee Han .
CANADIAN JOURNAL OF EMERGENCY MEDICINE, 2017, 19 (01) :18-25
[35]   A prospective investigation of the prognosis of noncardiac chest pain in emergency department patients [J].
Foldes-Busque, Guillaume ;
Dionne, Clermont E. ;
Tremblay, Marie-Andree ;
Turcotte, Stephane ;
Fleet, Richard P. ;
Archambault, Patrick M. ;
Denis, Isabelle .
JOURNAL OF PSYCHOSOMATIC RESEARCH, 2024, 186
[36]   A prospective validation of the HEART score for chest pain patients at the emergency department [J].
Backus, B. E. ;
Six, A. J. ;
Kelder, J. C. ;
Bosschaert, M. A. R. ;
Mast, E. G. ;
Mosterd, A. ;
Veldkamp, R. F. ;
Wardeh, A. J. ;
Tio, R. ;
Braam, R. ;
Monnink, S. H. J. ;
van Tooren, R. ;
Mast, T. P. ;
van den Akker, F. ;
Cramer, M. J. M. ;
Poldervaart, J. M. ;
Hoes, A. W. ;
Doevendans, P. A. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2013, 168 (03) :2153-2158
[37]   Sex Differences in Cardiac Troponin Testing in Patients Presenting to the Emergency Department with Chest Pain [J].
Humphries, Karin H. ;
Gao, Min ;
Lee, May K. ;
Izadnegahdar, Mona ;
Holmes, Daniel T. ;
Scheuermeyer, Frank X. ;
Mackay, Martha ;
Mattman, Andre ;
Grafstein, Eric .
JOURNAL OF WOMENS HEALTH, 2018, 27 (11) :1327-1334
[38]   Opportunities and Challenges of Computed Tomography Coronary Angiography in the Investigation of Chest Pain in the Emergency Department-A Narrative Review [J].
Premaratne, Manuja ;
Garcia, Gloria Patricia ;
Thomas, William ;
Hameed, Shaiq ;
Leadbeatter, Ashley ;
Htun, Nay ;
Dwivedi, Girish ;
Kaye, David M. .
HEART LUNG AND CIRCULATION, 2023, 32 (03) :307-314
[39]   The potential role for the use of cardiac computed tomography angiography for the acute chest pain patient in the emergency department [J].
Wilson, Sean R. ;
Min, James K. .
JOURNAL OF NUCLEAR CARDIOLOGY, 2011, 18 (01) :168-176
[40]   Role of cardiac computed tomography and magnetic resonance imaging in the evaluation of acute chest pain in the emergency department [J].
Ali Salah ;
David J. Moliterno ;
Roger Humphries ;
Mushabbar A. Syed .
The International Journal of Cardiovascular Imaging, 2008, 24 :331-342