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

Johnson, Thorsten R. C.; Nikolaou, Konstantin; Wintersperger, Bernd J.; Knez, Andreas; Boekstegers, Peter; Reiser, Maximilian; Becker, Christoph R.

doi:10.2214/ajr.05.1153

Cited by 145 publications

(68 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, because of its semi-invasive nature, it is difficult to apply to all patients. The recently developed multidetector row computed tomography (MDCT) is a powerful tool that enables rapid and specific diagnosis of aortic pathology [12]. Recent studies demonstrated the usefulness of MDCT over TEE for detection of AAA [13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Characterization of the Infarct Pattern Caused by Vulnerable Aortic Arch Atheroma: DWI and Multidetector Row CT Study

et al. 2012

View full text Add to dashboard Cite

Background: Aortic arch atheroma (AAA) has been accepted as a possible embolic source in patients with ischemic stroke, especially cryptogenic stroke. However, despite its well-known role as a risk factor for stroke, research focused on the mechanism or characteristics of stroke caused by AAA is insufficient. In this study, we aimed to evaluate clinical and radiological characteristics including lesion pattern on DWI in acute stroke patients associated with vulnerable AAA detected by multidetector row computed tomography (MDCT). Methods: From September 2008 through May 2011, patients who presented with acute ischemic stroke and underwent MDCT were found in a prospective stroke registry. Patients without evident stroke etiology were included and classified by presence of vulnerable AAA. Vulnerable AAA was defined as (i) at least 6 mm thick adjacent to the aortic wall; (ii) ulcerated plaque, or (iii) soft plaque. Soft plaque was defined as the presence of clearly visualized area of hypoattenuation (<80 Hounsfield units) suggestive of thrombus. The patients without vulnerable AAA were classified as no/simple AAA group. The characteristics of diffusion-weighted MRI (DWI) lesions were analyzed in terms of the number and size of the lesions, and the involved vascular territories. Results: A total of 63 cryptogenic stroke patients were included in this study. Vulnerable AAA was observed in 15 (23.8%) patients. The patients with vulnerable AAA were older than those with no/simple AAA (p = 0.026). DWI analysis revealed that the vulnerable AAA group had a greater chance of having multiple and small lesions in multiple vascular territories that were mainly located in cortical and border-zone regions than the no/simple AAA group. Multiple logistic regression analysis showed that age (odds ratio 1.17; 95% confidence interval 1.02–1.34) and multiple small lesions in multiple vascular territories (odds ratio 33.18; 95% confidence interval 4.26–258.45) were independently associated with vulnerable AAA. Conclusion: Vulnerable AAA is independently associated with a DWI pattern characterized by multiple small scattered lesions in multiple vascular territories in conjunction with age. It may help determine stroke mechanism quickly and easily, and provide more information about the pathomechanism of vulnerable AAA-related stroke.

show abstract

Section: Introductionmentioning

confidence: 99%

Characterization of the Infarct Pattern Caused by Vulnerable Aortic Arch Atheroma: DWI and Multidetector Row CT Study

et al. 2012

View full text Add to dashboard Cite

show abstract

“…9,10 The recently introduced 64-multidetector-row CT (MDCT) is a powerful tool that enables rapid, noninvasive, and specific diagnosis of aortic pathology. 11,12 Recent studies show that MDCT is comparable to TEE in measuring plaque thickness, discovering ulceration, and evaluating plaque characteristics. 13,14 However, the role of MDCT-detected AAD in stroke recurrence has not yet been investigated.…”

mentioning

confidence: 99%

Is Aortic Atherothrombotic Disease Detected Using Multidetector-Row CT Associated With an Increased Risk of Early Ischemic Lesion Recurrence After Acute Ischemic Stroke?

Kim

Jang

et al. 2012

Stroke

View full text Add to dashboard Cite

Background and Purpose-Multidetector-row CT (MDCT) is emerging as a new tool for diagnosing aortic atherothrombotic disease (AAD). We elucidated whether MDCT-detected AAD is associated with an increased risk of early ischemic lesion recurrence on diffusion-weighted MRI after ischemic stroke. Methods-A consecutive series of patients with acute ischemic stroke confirmed using diffusion-weighted MRI who were hospitalized within 48 hours after symptom onset and underwent MDCT were identified in a prospective stroke registry database. AAD on MDCT was defined as the presence of plaque formation that was noncalcified and Ն4 mm thick, ulcerative, or soft and thrombosed (vulnerable) in the proximal aortic arch. Ischemic lesion recurrence on diffusionweighted MRI was defined as the occurrence of any new lesion separate from the index lesion on follow-up diffusion-weighted MRI performed within 14 days after symptom onset.

show abstract

“…When it is desirable to examine the right heart, the injection protocol has to be modified so as to maintain adequate contrast on the right side of the heart during image acquisition. This can be achieved by adjusting the amount and flow rate of contrast medium to prolong the length of administration of the entire bolus [16]. However, monophasic injection of contrast medium alone at a uniform rate can result in streak artefacts.…”

Section: Mdct Acquisition Techniquementioning

confidence: 99%

Right heart on multidetector CT

Gopalan

2011

BJR

View full text Add to dashboard Cite

ABSTRACT. Right ventricular function plays an integral role in the pathogenesis and outcome of many cardiovascular diseases. Imaging the right ventricle has long been a challenge because of its complex geometry. In recent years there has been a tremendous expansion in multidetector row CT (MDCT) and its cardiac applications. By judicious modification of contrast medium protocol, it is possible to achieve good opacification of the right-sided cardiac chambers, thereby paving the way for exploring the overshadowed right heart. This article will describe the key features of right heart anatomy, review MDCT acquisition techniques, elaborate the various morphological and functional information that can be obtained, and illustrate some important clinical conditions associated with an abnormal right heart.

show abstract

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

Abstract: With current techniques, ECG-gated CT angiography of the entire chest has very good image quality. The protocol proved helpful in the differential diagnosis of acute chest pain.

Cited by 145 publications

References 35 publications

Characterization of the Infarct Pattern Caused by Vulnerable Aortic Arch Atheroma: DWI and Multidetector Row CT Study

Characterization of the Infarct Pattern Caused by Vulnerable Aortic Arch Atheroma: DWI and Multidetector Row CT Study

Is Aortic Atherothrombotic Disease Detected Using Multidetector-Row CT Associated With an Increased Risk of Early Ischemic Lesion Recurrence After Acute Ischemic Stroke?

Right heart on multidetector CT

Contact Info

Product

Resources

About