Abstract
BACKGROUND: Despite reports that multislice spiral computed tomography (MSCT) has high sensitivity and specificity in preselected patient populations, the routine clinical feasibility and utility of MSCT coronary angiography in patients with acute chest pain in the emergency department remains uncertain.
OBJECTIVES: We sought to determine whether 16-slice MSCT coronary angiography can provide diagnostically useful images in patients with acute chest pain in the emergency department. METHODS: Ninety-eight patients in the emergency department (41 men, 57 women; mean age � SD, 48.1 � 11.9 y) with acute chest pain underwent MSCT coronary angiography. Coronary calcium (Agatston) scoring was performed, followed by contrast-enhanced MSCT. Images were evaluated for mean image quality (MIQ) and for degree of stenosis. These data were correlated with body mass index (BMI; in kg/m2), heart rate, beat-to-beat variation, and calcium score to assess their influence on image quality.
RESULTS: The 28 patients (29%) with nondiagnostic MIQs had significantly higher BMIs (mean � SD, 32.9 � 9.1 vs 28.9 � 6.7; P
CONCLUSIONS: Sixteen-slice MSCT coronary angiography cannot routinely provide diagnostically useful images in patients with acute chest pain in the emergency department. � 2007 Society of Cardiovascular Computed Tomography. All rights reserved.