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[ECG-gated chest CT angiography: value for atypical chest pain evaluation]

G Bierry1, C Roy, X Buy

  • 1Service de Radiologie B, Hôpitaux Universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex.

Journal De Radiologie
|September 16, 2009
PubMed

Insights

Electrocardiogram-gated whole chest CT angiography (CTA) shows promise for evaluating acute chest pain. This technique aids in diagnosing various conditions, including coronary artery stenosis and pulmonary embolus, offering valuable insights into myocardial function.

Area of Science:

  • Cardiovascular Imaging
  • Thoracic Radiology
  • Diagnostic Imaging

Background:

  • Acute chest pain is a common presentation requiring rapid and accurate diagnosis.
  • Traditional diagnostic pathways can be time-consuming and may involve multiple imaging modalities.

Purpose of the Study:

  • To assess the utility of ECG-gated whole chest CT angiography (CTA) as a routine triage tool for patients presenting with acute chest pain.
  • To evaluate the diagnostic performance of this technique in identifying various causes of chest pain.

Main Methods:

  • Retrospective ECG-gated whole chest CTA was performed in 30 patients with acute atypical chest pain.
  • Analysis included coronary arteries, pulmonary arteries, aorta, and myocardium (function and morphology).
  • Inter-observer agreement was calculated between a resident and two senior radiologists.

Main Results:

  • The coronary artery segments, myocardium, and pulmonary arteries were analyzable in 84%, 90%, and 97% of cases, respectively.
  • A definitive diagnosis was established in 19 patients, identifying coronary artery stenosis, pulmonary embolus, aortic dissection, cardiomyopathy, lung abnormalities, and hiatus hernia.
  • Inter-observer agreement was high, ranging from 0.76 to 1.

Conclusions:

  • ECG-gated whole chest CTA is a promising tool for the comprehensive evaluation of acute chest pain.
  • The combined assessment of myocardial appearance and function provides additional diagnostic information.
  • This technique can potentially streamline the diagnostic process for acute chest pain.
Abstract

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