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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

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An Erratum to this article was published on 16 October 2007

An Erratum to this article was published on 16 October 2007

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 technique for patients with acute non-specific chest pain.

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Acknowledgements

The authors are grateful to (Donna Wolfe) for editorial assistance and to (Clotell Forde) for secretarial, data formatting and literature search assistance and (Iryna Rastorhuyeva) for assistance with data collection.

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Authors and Affiliations

  1. Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA

    Diana Litmanovitch, Giulia A. Zamboni, Pei-Jan P. Lin, Melvin E. Clouse & Vassilios Raptopoulos

  2. Department of Radiology, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA

    Diana Litmanovitch, Giulia A. Zamboni, Thomas H. Hauser, Pei-Jan P. Lin, Melvin E. Clouse & Vassilios Raptopoulos

  3. Department of Cardiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA

    Thomas H. Hauser

Authors
  1. Diana Litmanovitch
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  2. Giulia A. Zamboni
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  3. Thomas H. Hauser
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  4. Pei-Jan P. Lin
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  5. Melvin E. Clouse
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  6. Vassilios Raptopoulos
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Corresponding author

Correspondence to Diana Litmanovitch.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00330-007-0791-y

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Litmanovitch, D., Zamboni, G.A., Hauser, T.H. et al. ECG-gated chest CT angiography with 64-MDCT and tri-phasic IV contrast administration regimen in patients with acute non-specific chest pain. Eur Radiol 18, 308–317 (2008). https://doi.org/10.1007/s00330-007-0739-2

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