Seminars in Roentgenology
Volume 43, Issue 2 , Pages 136-144 , April 2008

Multidetector Computed Tomography in the Evaluation of Chest Pain in the Emergency Department

  • Thomas Flukinger, MD
    • ,
  • Charles S. White, MD

      Affiliations

    • Corresponding Author InformationAddress reprint requests to: Charles S. White, MD, Department of Diagnostic Radiology, University of Maryland Medical Center, 22 S. Greene Street, Baltimore, MD 21201.

References 

  1. McCraig LF, Burt CS. National Hospital Ambulatory Medical Care Survey: 2003 Emergency department summary. Advance data from vital and health statistics; no 358. Hyattsville, MD: National Center for Health Statistics; 2005;
  2. Achar SA, Kundu S, Norcross WA. Diagnosis of acute coronary syndrome. Am Fam Physician. 2005;72:119–126
  3. Balk EM, Ioannidis JP, Salem D, et al. Accuracy of biomarkers to diagnose acute cardiac ischemia in the emergency department: a meta-analysis. Ann Emerg Med. 2001;37:478–494
  4. Goodacre S, Locker T, Morris F, et al. How useful are clinical features in the diagnosis of acute, undifferentiated chest pain?. Acad Emerg Med. 2002;9:203–208
  5. Swap CJ, Nagurney JT. Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes. JAMA. 2005;294:2623–2629
  6. Zimetbaum PJ, Josephson ME. Use of the electrocardiogram in acute myocardial infarction. N Engl J Med. 2003;348:933–940
  7. Pope JH, Aufderheide TP, Ruthazer R, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med. 2000;342:1163–1170
  8. Christenson J, Innes G, McKnight D, et al. Safety and efficiency of emergency department assessment of chest discomfort. CMAJ. 2004;170:1803–1807
  9. Braunwald E, Antman EM, Beasley JW, et al. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction—summary article: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2002;40:1366–1374
  10. Margolis JR, Chen JT, Kong Y, et al. The diagnostic and prognostic significance of coronary artery calcification (A report of 800 cases). Radiology. 1980;137:609–616
  11. Kontos MC, Arrowood JA, Jesse RL, et al. Comparison between 2-dimensional echocardiography and myocardial perfusion imaging in the emergency department in patients with possible myocardial ischemia. Am Heart J. 1998;136:724–733
  12. McBride C, Kelsberg G, Calabretta N, et al. Clinical inquiries (What is the prognostic value of stress echocardiography for patients with atypical chest pain?). J Fam Pract. 2006;55(10):902–904
  13. Bulow H, Schwaiger M. Nuclear cardiology in acute coronary syndromes. Q J Nucl Med Mol Imaging. 2005;49:59–71
  14. Conti A, Gallini C, Costanzo E, et al. Early detection of myocardial ischaemia in the emergency department by rest or exercise (99m)Tc tracer myocardial SPECT in patients with chest pain and non-diagnostic ECG. Eur J Nucl Med. 2001;28:1806–1810
  15. Heller GV, Stowers SA, Hendel RC, et al. Clinical value of acute rest technetium-99m tetrofosmin tomographic myocardial perfusion imaging in patients with acute chest pain and non diagnostic electrocardiogram. J Am Coll Cardiol. 1998;31:1011
  16. Kawahito M, Kondo M, Abe Y, et al. Usefulness of technetium-99m tetrofosmin single-photon emission computed tomography for short-term risk stratification in patients with acute chest pain in the emergency room. J Cardiol. 2003;42(4):147–154
  17. Kwong RY, Schussheim AE, Rekhraj S, et al. Detecting acute coronary syndrome in the emergency department with cardiac magnetic resonance imaging. Circulation. 2003;107:531–537
  18. O’Rourke RA, Brundage BH, Froelicher VF, et al. American College of Cardiology/American Heart Association Expert Consensus Document on electron-beam computed tomography for the diagnosis and prognosis of coronary artery disease. J Am Coll Cardiol. 2000;36:326–340
  19. Agatston AS, Janowitz WR, Hildner FJ, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15:827–832
  20. Becker CR, Kleffel T, Crispin A, et al. Coronary artery calcium measurement: agreement of multirow detector and electron beam CT. AJR Am J Roentgenol. 2001;176:1295–1298
  21. Tanenbaum SR, Kondos GT, Veselik KE, et al. Detection of calcific deposits in coronary arteries by ultrafast computed tomography and correlation with angiography. Am J Cardiol. 1989;63:870–872
  22. Arad Y, Spadaro LA, Goodman K, et al. Predictive value of electron beam computed tomography of the coronary arteries (19-month follow-up of 1173 asymptomatic subjects). Circulation. 1996;93:1951–1953
  23. Budoff MJ, Georgiou D, Brody A, et al. Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: a multicenter study. Circulation. 1996;93:898–904
  24. Nallamothu BK, Saint S, Bielak LF, et al. Electron-beam computed tomography in the diagnosis of coronary artery disease: a meta-analysis. Arch Intern Med. 2001;161(6):833–838
  25. Laudon DA, Vukov LF, Breen JF, et al. Use of electron-beam computed tomography in the evaluation of chest pain patients in the emergency department. Ann Emerg Med. 1999;33:15–21
  26. McLaughlin VV, Balogh T, Rich S. Utility of electron beam computed tomography to stratify patients presenting to the emergency room with chest pain. Am J Cardiol. 1999;84:327–328
  27. Georgiou D, Budoff MJ, Kaufer E, et al. Screening patients with chest pain in the emergency department using electron beam tomography: a follow-up study. J Am Coll Cardiol. 2001;38:105–110
  28. Achenbach S, Giesler T, Ropers D, et al. Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography. Circulation. 2001;103(21):2535–2538
  29. Knez A, Becker CR, Leber A, et al. Usefulness of multislice spiral computed tomography angiography for determination of coronary artery stenoses. Am J Cardiol. 2001;88:1191–1194
  30. Raff GL, Gallagher MJ, O’Neill WW, et al. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol. 2005;46(3):552–557
  31. Pugliese F, Mollet NR, Runza G, et al. Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris. Eur Radiol. 2006;16(3):575–582
  32. Leschka S, Alkadhi H, Plass A, et al. of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J. 2005;26(15):1482–1487
  33. Ropers D, Rixe J, Anders K, et al. Usefulness of multidetector row spiral computed tomography with 64- × 0.6-mm collimation and 330-ms rotation for the noninvasive detection of significant coronary artery stenoses. Am J Cardiol. 2006;97(3):343–348
  34. Oncel D, Oncel G, Karaca M. Coronary stent patency and in-stent restenosis: determination with 64-section multidetector CT coronary angiography—initial experience. Radiology. 2007;42(2):403–409
  35. Pache G, Saueressig U, Frydrychowicz A, et al. Initial experience with 64-slice cardiac CT: non-invasive visualization of coronary artery bypass grafts. Eur Heart J. 2006;27(8):976–980
  36. White CS, Kuo D, Kelemen M, et al. Chest pain evaluation in the Emergency Room: can multi-slice CT provide a comprehensive evaluation?. AJR Am J Roentgenol. 2005;185:533–540
  37. van der Vleuten PA, Willems TP, Gotte MJ, et al. Quantification of global left ventricular function: comparison of multidetector computed tomography and magnetic resonance imaging. a meta-analysis and review of the current literature. Acta Radiol. 2006;47(10):1049–1057
  38. Hoffmann U, Nagurney JT, Moselewski F, et al. Coronary multidetector computed tomography in the assessment of patients with acute chest pain. Circulation. 2006;114:2251–2260
  39. Ghersin E, Litmanovich D, Dragu R, et al. 16-MDCT Coronary Angiography Versus Invasive Coronary Angiography in Acute Chest Pain Syndrome: a blinded prospective study. AJR Am J Roentgenol. 2006;186:177–184
  40. Dorgelo J, Willems TP, Geluk CA, et al. Multidetector computed tomography-guided treatment strategy in patients with non-ST elevation acute coronary syndromes: a pilot study. Eur Radiol. 2005;15:708–713
  41. Rubinshtein R, Halon DA, Gaspar T, et al. Usefulness of 64-slice cardiac computed tomographic angiography for diagnosing acute coronary syndromes and predicting clinical outcome in emergency department patients with chest pain of uncertain origin. Circulation. 2007;115(13):1762–1768
  42. Sato Y, Matsumoto N, Ichikawa M, et al. Efficacy of multislice computed tomography for the detection of acute coronary syndrome in the emergency department. Circ J. 2005;69(9):1047–1051
  43. Gallagher MJ, Ross MA, Raff GL, et al. The diagnostic accuracy of 64-slice computed tomography coronary angiography compared with stress nuclear imaging in emergency department low-risk chest pain patients. Ann Emerg Med. 2007;49(2):125–136
  44. Goldstein JA, Gallagher MJ, O’Neill WW, et al. A randomized controlled trial of multi-slice coronary computed tomography for evaluation of acute chest pain. J Am Coll Cardiol. 2007;49(8):863–871
  45. Trabold T, Buchgeister M, Kuttner A, et al. Estimation of radiation exposure in 16-detector row computed tomography of the heart with retrospective ECG-gating. Rofo. 2003;175:1051–1055
  46. Poll LW, Cohnen M, Brachten S, et al. Dose reduction in multi-slice CT of the heart by use of ECG-controlled tube current modulation (“ECG pulsing”): phantom measurements. Rofo. 2002;174:1500–1505
  47. Earles J, Berman E, Curry C, et al. Prospectively gated axial coronary CTA: an evaluation of image quality, enhancement characteristics, reliability, and radiation dose. In: Radiological Society of North America Scientific Assembly and Annual Meeting Program. Oak Brook, IL: Radiological Society of North America; 2006;

PII: S0037-198X(08)00009-6

doi: 10.1053/j.ro.2008.01.008

Seminars in Roentgenology
Volume 43, Issue 2 , Pages 136-144 , April 2008

Article Tools

* Image Usage & Resolution