Limiting scan range of cardiac CT and the chance of missed acute aortic syndrome

详细信息    查看全文

• 作者：Jongdae Park ; MD ; Joonghee Kim ; MD ; MS¹ ; Kyuseok Kim ; MD ; PhD ; ^{dremkks@snubh.org" class="auth_mail" title="E-mail the corresponding author}
• 刊名：The American Journal of Emergency Medicine
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：34
• 期：10
• 页码：2007-2010
• 全文大小：321 K

文摘

Recently, dedicated cardiac computed tomography (CT) has been performed to rule out acute coronary syndrome in patients with chest pain equivalents. However, acute aortic syndrome (AAS) could mimic acute coronary syndrome. We investigated the reliability of CT with a limited scan range for the detection of AAS.

Methods

Patients older than 18 years with a diagnosis of AAS were included for a 10-year period. We reviewed all patients' electronic medical record and cardiac CT scan images. The AAS lesions outside of the upper or lower margin of the cardiac CT scan range were measured. Other abnormalities defined as indirect evidence of AAS such as pericardial effusion were also collected.

Results

Of a total of 309 cases, 6 (1.9%; 95% confidence interval, 0.71-4.17) patients had aortic lesions outside of the cardiac CT scan range. One patient had an aortic lesion above the cardiac CT scan range, and 5 patients had aortic lesions below the cardiac CT scan range.

Conclusions

Aortic lesions outside of the cardiac CT scan range were not rare. Therefore, using a cardiac CT might not guarantee ruling out AAS completely.