Chinnaiyan Kavitha M, Raff Gilbert L
Department of Cardiology, William Beaumont Hospital, 3601 W. 13 Mile Road, Royal Oak, MI, 48073, USA.
Curr Treat Options Cardiovasc Med. 2016 Oct;18(10):62. doi: 10.1007/s11936-016-0484-4.
Acute chest pain (ACP) represents a clinical as well as economic challenge, often resulting in time-consuming, expensive evaluations to avoid missed diagnosis of acute coronary syndromes (ACSs). Coronary CT angiography (CTA) is an attractive noninvasive technique for use in the emergency department (ED) due to its high accuracy and negative predictive value. Recent studies have demonstrated that coronary CTA can aid in safe, rapid, and cost-efficient triage of these patients. Additional applications of plaque characterization, fractional flow analysis, and CT perfusion imaging hold promise in providing incremental data in patients with suspected ACS. In this review, we examine the data for the use of coronary CTA in acute chest pain, novel applications of the technology, and best practice for its use in the ED.
急性胸痛（ACP）是一项临床和经济挑战，常常需要进行耗时且昂贵的评估，以避免漏诊急性冠脉综合征（ACS）。冠状动脉CT血管造影（CTA）因其高准确性和阴性预测价值，是急诊科（ED）颇具吸引力的无创技术。近期研究表明，冠状动脉CTA有助于对这些患者进行安全、快速且经济高效的分诊。斑块特征分析、血流分数分析和CT灌注成像等其他应用有望为疑似ACS患者提供更多数据。在本综述中，我们审视了冠状动脉CTA在急性胸痛中的应用数据、该技术的新应用以及其在急诊科的最佳应用实践。
