Triple Rule-Out in Flash Speed Thorax Scanned in Less Than a Second
SOMATOM Definition Flash Dual Source Scanning
Michael Lell, MD* , Fabian Hinkmann, MD* , Andreas Blaha**
*Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
**Business Unit CT, Siemens Healthcare, Forchheim, Germany | 2009-05-25
A 64-year-old male patient was referred to the radiology department with acute chest pain. ECG and lab tests did not suggest myocardial infarction.
An ECG triggered triple rule-out protocol was selected to evaluate coronary artery disease, pulmonary embolism, aortic dissection, and other thoracic disease.
The ultra-fast scan speed of 43 cm per second allowed a reduction of i.v. contrast injection down to 80 ml followed by a saline chaser bolus. The chosen scan direction was caudo-cranial to assure a homogenous contrast distribution in the coronary and pulmonary arteries. No high-grade stenoses, only minor calcified plaques at the aortic root next to the ostium of the right coronary artery (RCA) and a non-calcified plaque of the LAD have been shown by the curved planar reconstructions of the coronary arteries. The entire thoracic aorta did not show any signs of dissection. Bilateral pulmonary emboli were detected as well as emboli in subsegmental arteries of the lower lobe.
Split-second thorax imaging provides a very fast, non-invasive visualization of coronary arteries with simultaneous evaluation of the pulmonary arteries, thoracic aorta, and other intra-thoracic structures. By requiring less radiation-in this case only 1.9mSv (conversion factor 0.014)–CT further establishes itself as the first-line imaging test for assessing patients with suspected acute pulmonary embolism.
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