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ECG-Gated 64-MDCT Angiography in the Differential Diagnosis of Acute Chest Pain

Thorsten R. C. Johnson1, Konstantin Nikolaou1, Bernd J. Wintersperger1, Andreas Knez2, Peter Boekstegers2, Maximilian F. Reiser1 and Christoph R. Becker1

1 Department of Clinical Radiology, University of Munich, Grosshadern Campus, Marchioninistraße 15, 81377 Munich, Germany.
2 Department of Cardiology, Medical Clinic I, University of Munich, Grosshadern Campus, 81377 Munich, Germany.


Figure 1
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  		Fig. 1A —66-year-old woman with acute chest pain. Volume-rendered image of chest shows pulmonary vessels, coronary arteries, and aorta.

 

Figure 2
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  		Fig. 1B —66-year-old woman with acute chest pain. Volume-rendered image shows adequate contrast enhancement of coronary vessels.

 

Figure 3
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  		Fig. 1C —66-year-old woman with acute chest pain. CT scan shows segmental pulmonary embolism (arrow).

 

Figure 4
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  		Fig. 2A —75-year-old man with acute chest pain. Axial CT image shows dissection (black arrow) of aortic root and high-grade stenosis (white arrow) of left anterior descending coronary artery.

 

Figure 5
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  		Fig. 2B —75-year-old man with acute chest pain. Maximum intensity projection shows slightly angulated detailed view of stenosis of left anterior descending coronary artery.

 

Figure 6
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  		Fig. 3 —84-year-old man with acute chest pain. Volume-rendered image of chest in left anterior view shows venous bypass grafts from ascending aorta to right coronary artery and to circumflex branch of left coronary artery (white arrows). Distal part of severely altered left anterior descending coronary artery has narrow lumen (black arrow). Course of occluded arterial bypass graft from left internal mammary artery to left anterior descending coronary artery is marked by clips (arrowheads).

 

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