Michael Shapiro DO, Abstract Co-Author: Nothing to Disclose

Jonathan Dermot Dodd MD, Abstract Co-Author: Nothing to Disclose

Conrad Wittram MBChB, Abstract Co-Author: Nothing to Disclose

Joe Yo Hsu MD, Abstract Co-Author: Nothing to Disclose

Sanjeeva Prasad Kalva MD, Presenter: Research grant, Johnson & Johnson (Cordis Corporation) Research grant, Cook Group Incorporated Speaker, Johnson & Johnson (Cordis Corporation)

Khurram Nasir MD, Abstract Co-Author: Nothing to Disclose

Bob Liu PhD, Abstract Co-Author: Nothing to Disclose

John T. Nagurney, Abstract Co-Author: Nothing to Disclose

Mannudeep Karanvirsingh Kalra MD, Abstract Co-Author: Nothing to Disclose

John Nichols BA, Abstract Co-Author: Nothing to Disclose

Ricardo Caldeira Cury MD, Abstract Co-Author: Research grant, Pfizer Inc, New York, NY

Suhny Abbara MD, Abstract Co-Author: Consultant, E-Z-EM, Inc Medical Advisory Board, Partners Imaging

Ahmed Tawakol MD, Abstract Co-Author: Nothing to Disclose

Thomas Joseph Brady MD, Abstract Co-Author: Grant, Siemens AG

Udo Hoffmann MD, Abstract Co-Author: Research grant, Bayer AG Research grant, General Electric Company Research grant, Siemens AG Advisory Board, Vital Images, Inc Advisory Board, Siemens AG Advisory Board, Bayer AG

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Advances in CT technology may permit the evaluation of coronary disease, aortic dissection, and pulmonary embolism with a single contrast bolus and breath hold. We sought to determine whether 64-slice computed tomography angiography (CTA) allows for simultaneous visualization of the coronary arteries, thoracic aorta, and pulmonary arteries (CAP) with image quality comparable to routine CTA protocols.

We prospectively enrolled 20 patients who underwent CAP CTA. Image quality of CAP CTA was assessed qualitatively and quantitatively and compared to dedicated coronary (n=20) and pulmonary (n=10) CTA datasets using matched controls.

The mean amount of contrast and radiation dose was 132±10 ml and 17.8±1.8 mSv, 78±9 ml and 13.7±3.4 mSv, and 135 ml and 11.9±1.5 mSv for CAP CTA, coronary CTA, and pulmonary CTA; respectively (p=0.001). There was no difference in overall image quality (p=0.88), presence of motion artifacts (p=0.40), or enhancement of the proximal coronary arteries [median (interquartile range (IQR) for CNR was 12.5 (9.9-15.2) vs. 13.1 (10.3-16.9), p=0.17)] or thoracic aorta [264 (113-326) vs. 245 (107-295), p=0.34] between CAP CTA and the dedicated coronary CTA, respectively. However, contrast attenuation was higher in the pulmonary arteries with CAP CTA [363 (253-424)] vs. the standard pulmonary CTA protocol [235 (182-269), p=0.0001].

Using an individually tailored single contrast injection, CAP CTA permits simultaneous visualization of the coronary arteries, thoracic aorta, and pulmonary arteries with excellent image quality. Further research is necessary to determine whether this protocol may enhance triage of patients with undifferentiated acute chest pain.

CAP MDCT imaging is feasible in patients presenting to the ED with acute chest pain and can provide excellent image quality, similar to the individual, decdiated CT protocols.

Shapiro, M, Dodd, J, Wittram, C, Hsu, J, Kalva, S, Nasir, K, Liu, B, Nagurney, J, Kalra, M, Nichols, J, Cury, R, Abbara, S, Tawakol, A, Brady, T, Hoffmann, U, et al, , et al, , A Novel Imaging Protocol to Visualize the Coronary Artery Tree, Thoracic Aorta, and Pulmonary Artery Vasculature with a Single Contrast Bolus and Twenty Second Scan Duration Using ECG-gated 64-slice MDCT.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5009953.html