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[双源CT在胸痛诊断中的应用]

[Dual-source CT in chest pain diagnosis].

作者信息

Johnson Thorsten R C, Nikolaou K, Fink C, Becker A, Knez A, Rist C, Reiser M F, Becker C R

机构信息

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

出版信息

Radiologe. 2007 Apr;47(4):301-9. doi: 10.1007/s00117-007-1480-1.

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.

摘要

背景

通过对肺动脉、冠状动脉和主动脉的成像,胸部CT血管造影可为不明原因的胸痛提供全面的诊断检查。本研究的目的是评估双源CT在该患者群体中的诊断准确性。

材料与方法

共有47例不明原因胸痛患者接受了西门子Somatom Definition CT检查。造影剂(优维显,先灵公司)的用量和流速根据体重进行调整。对检查结果进行图像质量、对比剂充盈情况评估,并参照最终临床诊断评估诊断准确性。

结果

所有检查均实现了足够的对比剂充盈。所有病例中冠状动脉的成像均具有诊断价值。41例患者的胸痛原因得以明确。诊断结果包括冠状动脉和心肌病变、瓣膜疾病、主动脉瘤和夹层、肺栓塞以及肺部实变。

结论

胸部双源CT血管造影即使在心率较高时也能提供非常好的图像质量,从而在急性胸痛患者中实现较高的诊断准确性。

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