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Dual-source-CT in der Diagnostik des Thoraxschmerzes

Dual-source CT in chest pain diagnosis

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Zusammenfassung

Hintergrund

Die EKG-getriggerte CT-Angiographie kann mit der Darstellung von Koronar-, Lungenarterien und Aorta eine umfassende Abklärung des unklaren Thoraxschmerzes leisten. Ziel unserer Untersuchungen war es, die diagnostische Wertigkeit des Dual-source-CT in diesem Patientenkollektiv festzustellen.

Material und Methodik

47 Patienten mit unklarem Thoraxschmerz wurden an einem Siemens Somatom Definition untersucht. Menge und Injektionsgeschwindigkeit des Kontrastmittels (Ultravist, Schering) wurden auf das Körpergewicht adaptiert. Die Untersuchungen wurden hinsichtlich der Bildqualität und Kontrastierung sowie der diagnostischen Genauigkeit im Vergleich zur endgültigen klinischen Diagnose beurteilt.

Ergebnisse

Bei allen Untersuchungen wurde eine ausreichende Kontrastierung erzielt. Die Darstellung der Koronararterien war in allen Fällen diagnostisch. Die Ursache des Thoraxschmerzes konnte bei 41 Patienten identifiziert werden. Das Diagnosenspektrum umfasste koronare und myokardiale Ursachen, Klappenfehler, Aortenaneurysmata und Dissektionen, Lungenembolien und pneumonische Infiltrate.

Schlussfolgerung

Die Thoraxangiographie am DSCT bietet auch bei hohen Herzfrequenzen eine sehr gute Bildqualität, sodass auch bei akutem Thoraxschmerz eine hohe diagnostische Aussagekraft gewährleistet ist.

Abstract

Background

With the depiction of pulmonary arteries, coronary arteries, and the aorta, CT angiography of the chest offers a comprehensive diagnostic work-up of unclear chest pain. The aim of this study was to assess the diagnostic accuracy of dual-source CT in this patient group.

Materials and methods

A total of 47 patients suffering from unclear chest pain were examined with a Siemens Somatom Definition. Volume and flow of contrast media (Ultravist, Schering) were adapted to the body weight. The examinations were evaluated with regard to image quality and contrast opacification and to the diagnostic accuracy with reference to the final clinical diagnosis.

Results

Adequate contrast opacification was achieved in all examinations. The depiction of the coronary arteries was diagnostic in all cases. The cause of chest pain could be identified in 41 cases. Among the diagnoses were coronary and myocardial pathologies, valvular disease, aortic aneurysms and dissections, pulmonary embolism, and pneumonic consolidation.

Conclusion

DSCT angiography of the chest offers a very good image quality even at high heart rates so that a high diagnostic accuracy is achieved in patients with acute chest pain.

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Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum Großhadern der Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland

    Thorsten R.C. Johnson, K. Nikolaou, C. Fink, C. Rist, M.F. Reiser & C.R. Becker

  2. Abteilung Kardiologie, Medizinische Klinik I, Klinikum Großhadern der Ludwig-Maximilians-Universität München, München, Deutschland

    A. Becker & A. Knez

Authors
  1. Thorsten R.C. Johnson
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  2. K. Nikolaou
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  3. C. Fink
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  4. A. Becker
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  5. A. Knez
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  6. C. Rist
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  7. M.F. Reiser
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  8. C.R. Becker
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Correspondence to Thorsten R.C. Johnson.

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Johnson, T., Nikolaou, K., Fink, C. et al. Dual-source-CT in der Diagnostik des Thoraxschmerzes. Radiologe 47, 301–309 (2007). https://doi.org/10.1007/s00117-007-1480-1

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  • DOI: https://doi.org/10.1007/s00117-007-1480-1

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