Bastarrika G, Schoepf U J
Unidad de Imagen Cardiaca, Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
Radiologia. 2011 Oct;53 Suppl 1:30-42. doi: 10.1016/j.rx.2011.02.010. Epub 2011 Jul 30.
Chest pain is a challenging clinical problem in the emergency department. Despite advances in clinical diagnosis, many patients with atypical chest pain are needlessly hospitalized and others are mistakenly discharged. Faced with the specific clinical situation in which a patient has chest pain, an initially normal or inconclusive electrocardiogram, and normal cardiac biomarkers, multislice CT has proven useful for ruling out the conditions that involve the greatest morbidity and mortality and for establishing the cause of pain. This article reviews the current usefulness of multislice CT in the diagnostic workup of patients presenting at the emergency department with chest pain. We review the technique, define the most appropriate population, describe the acquisition protocols, and discuss the advantages and disadvantages of each study protocol.
胸痛是急诊科中一个具有挑战性的临床问题。尽管临床诊断取得了进展,但许多非典型胸痛患者被不必要地住院,而其他患者则被错误地出院。面对患者出现胸痛、初始心电图正常或不确定以及心脏生物标志物正常的特定临床情况,多层螺旋CT已被证明有助于排除那些具有最高发病率和死亡率的疾病,并确定疼痛原因。本文综述了多层螺旋CT在急诊科胸痛患者诊断检查中的当前应用价值。我们回顾了该技术,确定了最合适的人群,描述了采集方案,并讨论了每种研究方案的优缺点。