Negative ECG-gated cardiac CT in patients with low-to-moderate risk chest pain in the emergency department: 1-year follow-up.

Objective: The purpose of this article is to determine the frequency of adverse cardiac events during the year following a negative cardiac CT angiogram in a population of patients presenting to the emergency department with low-to-moderate risk chest pain.

Subjects And Methods: Eighty-one consecutive patients who had standard of care evaluation for low-to-moderate risk chest pain in the emergency department were enrolled and consented to have a cardiac CT angiogram added to their workup and to have follow-up for 1 year. Eleven patients were excluded, six because their cardiac CT examinations were unsuccessful, four because of a positive cardiac CT angiogram result, and one was lost to follow-up.

Triphasic contrast bolus for whole-chest ECG-gated 64-MDCT of patients with nonspecific chest pain: evaluation of arterial enhancement and streak artifact.

Objective: The purpose of this study was to evaluate the use of a triphasic contrast bolus for ECG-gated CT in the assessment of chest pain by measuring vascular luminal attenuation and determining the degree of contrast-related streak artifact.

Materials And Methods: We reviewed the images from 44 ECG-gated CT examinations performed with a coronary contrast bolus modified for imaging of the entire chest. Luminal attenuation achieved with the resulting triphasic bolus was measured at specified vascular locations in the right side of the heart, pulmonary arteries, coronary arteries, and thoracic aorta.

Low-risk patients with chest pain in the emergency department: negative 64-MDCT coronary angiography may reduce length of stay and hospital charges.

Objective: The current standard-of-care workup of low-risk patients with chest pain in an emergency department takes 12-36 hours and is expensive. We hypothesized that negative 64-MDCT coronary angiography early in the workup of such patients may enable a shorter length of stay and reduce charges.

Materials And Methods: The standard-of-care evaluation consisted of serial cardiac enzyme tests, ECGs, and stress testing.

Whole-chest 64-MDCT of emergency department patients with nonspecific chest pain: Radiation dose and coronary artery image quality with prospective ECG triggering versus retrospective ECG gating.

Objective: The purpose of this study was to compare the patient radiation dose and coronary artery image quality of long-z-axis whole-chest 64-MDCT performed with retrospective ECG gating with those of CT performed with prospective ECG triggering in the evaluation of emergency department patients with nonspecific chest pain.

Subjects And Methods: Consecutively registered emergency department patients with nonspecific low-to-moderate-risk chest pain underwent whole-chest CT with retrospective gating (n = 41) or prospective triggering (n = 31). Effective patient radiation doses were estimated and compared by use of unpaired Student's t tests.

Prospective versus retrospective ECG gating for 64-detector CT of the coronary arteries: comparison of image quality and patient radiation dose.

Purpose: To compare image quality and patient radiation dose in a group of patients who underwent 64-detector computed tomography (CT) coronary angiography performed with prospective electrocardiographic (ECG) gating with image quality and radiation dose in a group of patients matched for clinical features who underwent 64-detector CT coronary angiography performed with retrospective ECG gating.

Materials And Methods: Institutional review board approval was obtained for this HIPAA-compliant study, and the informed consent requirement was waived due to the retrospective study design. Two independent reviewers separately scored coronary artery segment image quality and overall image quality for 100 cardiac CT studies (50 in each group).