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Background: In our study, we aimed to estimate utility of TRO CTA to guide clinical decision in acute chest pain patients with intermediate risk to acute coronary syndrome (ACS) in the emergency department.Methods and material: Our study population included 45 acute chest pain patients with intermediate-risk ACS. All these patients had done TRO CTA to access any pathological conditions in the coronary artery, pulmonary artery, aorta and thoracic diseases that may be the cause of their complaint. Follow-up was done in all patients for 60 days.Results: Among the 45 patients, we were able to discharge 44.4% (20 out of 45) of our population safely to home with no need for further diagnostic cardiac testing. The rest of the patients were classified into significant coronary artery disease 40% (18 out of 45), 8.8% (4 out of 45) had acute aortic lesions and 6.6% (3 out 45) had pulmonary artery embolization.Conclusions: Triple Role Out CT angiography (TRO CTA) is not only an effective protocol for exclusion of ACS with high specificity compared to dedicated coronary CTA but also in the diagnosis of acute chest pain due to other vascular and non-vascular causes helping decision-making strategy for admission in the emergency department.

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Background Volumetric MR neuroimaging can visualize the pattern of hippocampal subfield atrophic changes in AD. This can be used as a biomarker in early diagnosis of AD and allow early treatment to improve memory, behavioral symptoms, and delay the cognitive deterioration. The aim of this work is to assess the role of the volumetric study of different hippocampal subfields as a post-processing technique of structural MR imaging in patients with Alzheimer’s disease of different severity of cognitive functions. The regional ethics committee approved the study and written informed consent was obtained from all participants. In the duration from 2016 to 2018, a cross-sectional study was conducted on 30 patients (17 males and 13 females) and 15 healthy elderly controls (9 males and 6 females) referred to the Radiodiagnosis Department from the Neuropsychiatry Department. Patients were diagnosed with AD by clinical examination and using the Mini Mental State Examination (MMSE) and the Clinical Dementia Rating scale (CDR) as a measure of general cognitive performance. Results CA1 and subiculum subfields were significantly reduced in size in patients with Alzheimer’s disease in relation to the age-matched control group (P < 0.05). This finding was positively correlated with the MMSE score and negatively correlated with CDR clinical tests. No significant atrophy was found among other hippocampal subfields in the patients’ group. Conclusion This study proposed a new approach to detect atrophy in hippocampal subfields, using MR volumetric study of high-resolution T1 images, that can be used as a biomarker in the diagnosis of AD patients and differentiating them from elderly control subjects which is important in early diagnosis of AD and hence the proper treatment to improve the prognosis of the cognitive function.