Application Of 16-slices Spiral CT In Acute Chest Pain Diagnosis

In the paper technique characteristics of CTCA,CTPA and aortic CTA have been analyzed and studied and one time of the enhanced scan of 16-slice MSCT is carried out to achieve CTCA,CTPA and aortic CTA examination together, aiming at diagnosis of acute high-risk chest pain.Clear display of pulmonary artery,thoracic artery and coronary artery has got,which is required by diagnosis of acute high-risk chest pain.This provides an accurate,convenient examination method to the clinical diagnosis of acute high-risk chest pain.There is no similar research report on using 16-slice MSCT to be seen till now.Objective:By one 16-slice MSCT scan to achieve CTCA,CTPA and aortic CTA examination together,to explore the application value of 16-slice spiral CT in high-risk chest pain patient diagnosis.Method:38 inpatients and emergency patients with chest pain,chest distress and precardial discomfort come from the fourth center hospital of Tianjin city(21 males and 17 females,aged 47～76 years) have been investigated.TOSHIBA AQUILION 16-slice spiral CT is used.Patients were underwent chest plain scanning first,and then enhanced scanning using retrospectively ECG-gated technology.Scanning range is from supra-arch to inferior phrenia;120-140ml Iohexol(350mg I/ml) was injected from elbow vein and 40ml tracking normal saline as well.Scanning began when both the region of interest(ROI) was selected in aortic arch with tracking technology of contrast medium(surestart) and CT values increased 110-120Hu.After scanning finished,images from R-R interval at each time phase were reconstructed based on preview plane of middle segment slice of right coronary artery.At last,coronary artery was observed usinng VR and CPR methods.Pulmonary artery was examined with cinema display,VR and MIP methods.Aorta was reconstructed and observed with MPR, CPR and VR methods.Results:Higher segmental pulmonary artery,thoracic artery,main(left and right) coronary artery and its main branches are clearly shown by one time of 16-slice spiral CT scan.There are 34 cases with coronary artery stenosis,4 cases with pulmonary artery embolism,and 2 cases with aortic dissection are examined.247 coronary artery branches of 38 cases are shown clearly,of which 47 branches are artery stenosis.GradeⅣ-Ⅴbranches of pulmonary artery could be clearly observed with MIP,VR and cinema display methods and even gradeⅥcould be shown clearly.4 cases with pulmonary artery embolism are examined.Conclusion:One arterial phase dynamic enhanced scanning of 16-slice MSCT can display pulmonary artery,thoracic artery and coronary artery.This is very important for the diagnosing and differentially diagnosing cause chest pain.It provides a noninvasive,credible examination method to the clinical diagnosis of acute high-risk chest pain,and has extensive society benefit and good economic benefit.