[Multidetector-row spiral computed tomography in chest emergencies].

Area of Science:

• Radiology
• Cardiovascular Imaging

Background:

• Advances in multidetector-row computed tomography (MDCT) with ECG gating enable differentiated examination protocols.
• Acute chest pain assessment requires strict patient triage due to varying radiation doses between protocols.

Purpose of the Study:

• To evaluate the feasibility and diagnostic utility of MDCT protocols for acute chest pain.
• To determine which anatomical structures can be assessed with standard versus dedicated MDCT protocols.

Main Methods:

• Utilized ECG-gated MDCT with differentiated examination protocols.
• Compared standard chest MDCT protocols with dedicated protocols for specific anatomical regions.
• Assessed simultaneous opacification of pulmonary arteries, aorta, and coronary arteries using dedicated contrast injection protocols.

Main Results:

• Standard CT datasets adequately assess pulmonary arteries, aortic arch, and descending aorta.
• ECG synchronization is essential for evaluating coronary arteries and the ascending aorta.
• MDCT for acute chest pain shows high negative predictive value, with minimal patient preparation needed.

Conclusions:

• MDCT with ECG gating is a powerful tool for acute chest pain assessment.
• Protocol selection is crucial for balancing diagnostic yield, radiation dose, and cost-effectiveness.
• Further prospective studies are needed to establish evidence-based guidelines and cost-effectiveness.