Chest Pain Evaluation in the Emergency Department: Can MDCT Provide a Comprehensive Evaluation?
Charles S. White1,
Dick Kuo2,
Mark Kelemen3,
Vineet Jain1,
Amy Musk1,
Eram Zaidi1,
Katrina Read4,
Clint Sliker1 and
Rajnish Prasad3
1 Department of Diagnostic Radiology, University of Maryland School of Medicine,
22 S Greene St., Baltimore, MD 21201.
2 Division of Emergency Medicine, Department of Surgery, University of Maryland
School of Medicine, Baltimore, MD 21201.
3 Division of Cardiology, Department of Internal Medicine, University of
Maryland School of Medicine, Baltimore, MD 21201.
4 Clinical Scientist, Philips Medical Systems, Department of Radiology,
University of Maryland School of Medicine, Baltimore, MD.
View larger version (17K):
[in a new window]
|
Fig. 1A —Radiology report forms. Initial (A) and final
(B) case report forms. Final form also included a coronary artery
scoring sheet (not shown).
|
|
View larger version (19K):
[in a new window]
|
Fig. 1B —Radiology report forms. Initial (A) and final
(B) case report forms. Final form also included a coronary artery
scoring sheet (not shown).
|
|
View larger version (136K):
[in a new window]
|
Fig. 2A —48-year-old man who presented to emergency department with
chest pain and normal coronary arteries by CT angiography. Curved planar
reformations from MDCT show right coronary artery (A) and left anterior
descending artery (B).
|
|
View larger version (140K):
[in a new window]
|
Fig. 2B —48-year-old man who presented to emergency department with
chest pain and normal coronary arteries by CT angiography. Curved planar
reformations from MDCT show right coronary artery (A) and left anterior
descending artery (B).
|
|
View larger version (155K):
[in a new window]
|
Fig. 3A —52-year-old man who presented to emergency department with
chest pain. Curved planar reformation from CT angiogram from MDCT shows area
of proximal left anterior descending artery (LAD) stenosis
(arrow).
|
|
View larger version (154K):
[in a new window]
|
Fig. 3B —52-year-old man who presented to emergency department with
chest pain. Coronary angiogram confirms LAD stenosis (arrow).
|
|
View larger version (97K):
[in a new window]
|
Fig. 4 —56-year-old woman who presented to emergency department with
chest pain. Left lower lobe pneumonia was found on MDCT. No coronary stenosis
was identified.
|
|
View larger version (112K):
[in a new window]
|
Fig. 5 —60-year-old man who presented to emergency department with
chest pain. Axial MDCT scan shows pulmonary embolism in right middle lobe
pulmonary artery (arrow).
|
|
View larger version (72K):
[in a new window]
|
Fig. 6A —60-year-old woman who presented to emergency department with
chest pain. Curved planar reformation from CT angiogram on MDCT was
interpreted as negative. Arrow points to narrowed branch that was not
identified prospectively.
|
|
View larger version (117K):
[in a new window]
|
Fig. 6B —60-year-old woman who presented to emergency department with
chest pain. Coronary angiogram shows a 50–60% stenosis (arrow)
of diagonal branch.
|
|
View larger version (82K):
[in a new window]
|
Fig. 6C —60-year-old woman who presented to emergency department with
chest pain. Repeat curved planar reformation produced after discrepancy was
reported suggests presence of stenotic area (arrow) in
retrospect.
|
|
View larger version (145K):
[in a new window]
|
Fig. 7 —56-year-old man who presented to emergency department with
history of myocardial infarction (MI) and chest pain. MDCT scan shows
endocardial apical perfusion defect (arrows). Patient was
asymptomatic at time of scanning with negative acute MI evaluation, and defect
was deemed to be chronic.
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2005 by the American Roentgen Ray Society.
