Cardiac CT in the Assessment of Acute Chest Pain in the Emergency Department

被引:25
|
作者
Bastarrika, Gorka [1 ]
Thilo, Christian [1 ,2 ]
Headden, Gary F. [3 ]
Zwerner, Peter L. [2 ]
Costello, Philip [1 ]
Schoepf, U. Joseph [1 ,2 ]
机构
[1] Med Univ S Carolina, Dept Radiol & Radiol Sci, Charleston, SC 29425 USA
[2] Med Univ S Carolina, Dept Med, Div Cardiol, Charleston, SC 29425 USA
[3] Med Univ S Carolina, Dept Med, Div Emergency Med, Charleston, SC 29425 USA
关键词
acute chest pain; acute coronary syndrome; coronary artery disease; CT; triple rule-out; DUAL-SOURCE CT; ACUTE MYOCARDIAL-INFARCTION; SPIRAL COMPUTED-TOMOGRAPHY; CORONARY-ARTERY CALCIUM; ELECTRON-BEAM TOMOGRAPHY; TUBE CURRENT MODULATION; NORTH-AMERICAN-SOCIETY; LOW-DOSE CT; DIAGNOSTIC-ACCURACY; MULTIDETECTOR-ROW;
D O I
10.2214/AJR.08.2265
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. The purpose of this article is to describe the current role of ECG-synchronized CT in the evaluation of patients with acute chest pain (triple rule-out) in the emergency department. We discuss clinical contexts of the chest pain algorithm, technical improvements that have enabled CT to attain its current role for this application, scan protocols and radiation considerations, the evidence base regarding diagnostic and prognostic performance, and initial data on the cost-effectiveness of this promising emerging test. CONCLUSION. Currently available evidence suggests that CT-based approaches with modern scan technology are safe, accurate, and potentially cost-saving, although large-scale clinical trials are needed to ascertain the precise role of CT in the evaluation of acute chest pain.
引用
收藏
页码:397 / 409
页数:13
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