J Korean Radiol Soc. 2008 Apr;58(4):351-356. Korean.
Published online Apr 30, 2008.
Copyright © 2008 The Korean Society of Radiology
Original Article

Clinical Utility of Coronary CT Angiography with Low-dose Chest CT in the Evaluation of Patients with Atypical Chest Pain: A Preliminary Report

Soo Jin Lim, M.D., Ki Seok Choo, M.D.,2 Chang Won Kim, M.D.,2 Kun IL Kim, M.D.,2 Yeon Joo Jung, M.D.,2 June Hong Kim, M.D.,3 Han Chul Lee, M.D.,3 Kook Jin Chun, M.D.,3 Jun Kim, M.D.,3 and Ung Bae Jeon, M.D.4
    • Department of Cardiology, Kim Hae Bokum Hospital, Korea.
    • 2Department of Radiology, Pusan National University Hospital, Korea.
    • 3Department of Cardiology, Pusan National University Hospital, Korea.
    • 4Department of Radiology, Seoul National University Hospital, Korea.

Abstract

Purpose

To determine the clinical utility of coronary CT angiography (CCTA) with low-dose chest CT in the evaluation of patients with atypical chest pain.

Materials and Methods

Ninety-six patients (mean age 60.2 years; age range, 41-68 years; 70 males) were referred for CCTA with low-dose chest CT (16-slice MDCT, Siemens) for an evaluation of atypical chest pain. When significant stenoses (lumen diameter reduction > 50%) were detected on CCTA, invasive coronary angiography (CA) was performed as the standard of reference. In all patients, medical chart review or telephone contact with patients was used to evaluate the contribution of CCTA with low-dose chest CT to the final clinical diagnosis, at least 6 months after performing CCTA.

Results

Among 96 patients, seven patients (7%) had significant stenoses as detected on CCTA, whereas two patients (2%) had significant stenoses and five patients had insignificant stenoses or no stenosis, as detected on conventional catheter angiography. In 18 (19%) of the 89 patients without significant stenosis detected on CCTA, this protocol provided additional information that suggested or confirmed an alternate clinical diagnosis.

Conclusion

In patients with atypical chest pain, CCTA with low-dose chest CT could help to exclude ischemic heart disease and could provide important ancillary information for the final diagnosis.

Keywords
Coronary artery disease; Coronary angiography; Tomography, X-ray computed; Chest pain


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