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ECG-gated chest CT angiography with 64-MDCT and tri-phasic IV contrast administration regimen in patients with acute non-specific chest pain

Abstract

The purpose of this study was to evaluate chest CTA protocol using retrospective ECG-gating and triphasic IV contrast regimen for comprehensive evaluation of patients with acute non-specific chest pain. ECG-triggered dose modulation was used with a 64-MDCT scanner in 56 non-critically ill patients with acute nonspecific chest pain using triphasic IV regimen: 50 ml contrast followed by 50 ml 60% contrast/saline and 30 ml normal saline. Lungs, aorta, pulmonary and coronary arteries were graded on a 5-point scale (5, best). Aorta and pulmonary artery attenuation was measured and three coronary artery groups were evaluated. Comparison with invasive coronary angiography was obtained in nine patients on a per segment (16 total) basis. Dosimetry values were obtained. Studies were satisfactory in all patients (score >3). Aorta and pulmonary artery attenuation was >200 HU in 90.5%. Lung or pleura, non-cardiac vascular and coronary arteries disease were detected in 20, 11 and 16 patients, respectively. Median coronary angiography (grade 5) was significantly higher than acceptable for diagnosis grade 4 (p < 0.001). Per segment, weighted kappa statistic was 0.79 indicating substantial agreement with catheter angiography (p<0.001). Average DLP was 1,490 {+-} 412 mGy-cm. Gated 64-MDCT angiography with triphasic IV contrast is a robust multipurpose  More>>
Authors:
Litmanovitch, Diana; Zamboni, Giulia A; Lin, Pei-Jan P; Clouse, Melvin E; Raptopoulos, Vassilios; [1]  Harvard Medical School, Department of Radiology, Boston, MA (United States)]; Hauser, Thomas H; [2]  Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Cardiology, Boston, MA (United States)]
  1. Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Radiology, Boston, MA (United States)
  2. Harvard Medical School, Department of Radiology, Boston, MA (United States)
Publication Date:
Feb 15, 2008
Product Type:
Journal Article
Resource Relation:
Journal Name: European Radiology; Journal Volume: 18; Journal Issue: 2
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; CHEST; COMPUTERIZED TOMOGRAPHY; PAIN
OSTI ID:
21001566
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0938-7994; EURAE3; TRN: DE08F3581
Availability:
Available from: http://dx.doi.org/10.1007/s00330-007-0739-2
Submitting Site:
DEN
Size:
page(s) 308-317
Announcement Date:
Apr 14, 2008

Citation Formats

Litmanovitch, Diana, Zamboni, Giulia A, Lin, Pei-Jan P, Clouse, Melvin E, Raptopoulos, Vassilios, Harvard Medical School, Department of Radiology, Boston, MA (United States)], Hauser, Thomas H, and Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Cardiology, Boston, MA (United States)]. ECG-gated chest CT angiography with 64-MDCT and tri-phasic IV contrast administration regimen in patients with acute non-specific chest pain. Germany: N. p., 2008. Web. doi:10.1007/S00330-007-0739-2.
Litmanovitch, Diana, Zamboni, Giulia A, Lin, Pei-Jan P, Clouse, Melvin E, Raptopoulos, Vassilios, Harvard Medical School, Department of Radiology, Boston, MA (United States)], Hauser, Thomas H, &amp; Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Cardiology, Boston, MA (United States)]. ECG-gated chest CT angiography with 64-MDCT and tri-phasic IV contrast administration regimen in patients with acute non-specific chest pain. Germany. https://doi.org/10.1007/S00330-007-0739-2
Litmanovitch, Diana, Zamboni, Giulia A, Lin, Pei-Jan P, Clouse, Melvin E, Raptopoulos, Vassilios, Harvard Medical School, Department of Radiology, Boston, MA (United States)], Hauser, Thomas H, and Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Cardiology, Boston, MA (United States)]. 2008. "ECG-gated chest CT angiography with 64-MDCT and tri-phasic IV contrast administration regimen in patients with acute non-specific chest pain." Germany. https://doi.org/10.1007/S00330-007-0739-2.
@misc{etde_21001566,
title = {ECG-gated chest CT angiography with 64-MDCT and tri-phasic IV contrast administration regimen in patients with acute non-specific chest pain}
author = {Litmanovitch, Diana, Zamboni, Giulia A, Lin, Pei-Jan P, Clouse, Melvin E, Raptopoulos, Vassilios, Harvard Medical School, Department of Radiology, Boston, MA (United States)], Hauser, Thomas H, and Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Cardiology, Boston, MA (United States)]}
abstractNote = {The purpose of this study was to evaluate chest CTA protocol using retrospective ECG-gating and triphasic IV contrast regimen for comprehensive evaluation of patients with acute non-specific chest pain. ECG-triggered dose modulation was used with a 64-MDCT scanner in 56 non-critically ill patients with acute nonspecific chest pain using triphasic IV regimen: 50 ml contrast followed by 50 ml 60% contrast/saline and 30 ml normal saline. Lungs, aorta, pulmonary and coronary arteries were graded on a 5-point scale (5, best). Aorta and pulmonary artery attenuation was measured and three coronary artery groups were evaluated. Comparison with invasive coronary angiography was obtained in nine patients on a per segment (16 total) basis. Dosimetry values were obtained. Studies were satisfactory in all patients (score >3). Aorta and pulmonary artery attenuation was >200 HU in 90.5%. Lung or pleura, non-cardiac vascular and coronary arteries disease were detected in 20, 11 and 16 patients, respectively. Median coronary angiography (grade 5) was significantly higher than acceptable for diagnosis grade 4 (p < 0.001). Per segment, weighted kappa statistic was 0.79 indicating substantial agreement with catheter angiography (p<0.001). Average DLP was 1,490 {+-} 412 mGy-cm. Gated 64-MDCT angiography with triphasic IV contrast is a robust multipurpose technique for patients with acute non-specific chest pain. (orig.)}
doi = {10.1007/S00330-007-0739-2}
journal = []
issue = {2}
volume = {18}
place = {Germany}
year = {2008}
month = {Feb}
}