The value of abdominal aorta combined with routine one-stop TRO-CTA examination in the management of patients with acute chest pain

Tingting QU; Le Cao; Yanan LI; Lihong Chen; Ganglian Fan; Yannan Cheng; Yinxia Guo; Jianxin Guo

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The value of abdominal aorta combined with routine one-stop TRO-CTA examination in the management of patients with acute chest pain

VernacularTitle:腹主动脉联合常规一站式胸痛三联CTA检查在急性胸痛患者诊疗中的价值
Author: Tingting QU ¹ ; Le CAO ¹ ; Yanan LI ¹ ; Lihong CHEN ¹ ; Ganglian FAN ¹ ; Yannan CHENG ¹ ; Yinxia GUO ¹ ; Jianxin GUO ¹
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1. Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
Publication Type:Journal Article
Keywords: chest pain; one-stop triple rule-out computed tomography angiography (TRO-CTA); abdominal aortic CTA; examination process
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2024;45(4):542-546
CountryChina
Language:Chinese
Abstract: 【Objective】 To investigate the value of abdominal aortic combined with routine one-stop triple rule-out computed tomography angiography (TRO-CTA) in the examination of patients with acute chest pain. 【Methods】 A total of 1 482 patients with nontraumatic chest pain were included in this retrospective study. Of them 414 patients underwent the conventional TRO-CTA scanning while 1 068 patients underwent TRO-CTA that included the abdominal aorta (TRO-CTAwAA) under the request of clinicians. All scanning parameters were the same, except the scanning range for the third phase in TRO-CTA: conventional TRO-CTA covered only the thoracic aorta, while TRO-CTAwAA extended to the entire aorta. Patient etiology was investigated and the detection rates of major vessel abnormalities (aortic dissection, aneurysm, penetrating ulcer, intramural hematoma, vascular occlusion, and thrombosis) between the two groups was compared using chi square tests. The radiation dose (CTDIvol and DLP) and scanning time between the two groups were compared using analysis of variance (ANOVA). 【Results】 The TRO-CTAwAA had significantly higher detection rate of major artery abnormalities than the TRO-CTA group (35.1% vs. 4.8%, P<0.001). In the TRO-CTAwAA group, 26.5% of the vascular anomalies were detected in both the thoracic and abdominal aortas, and another 8.6% were seen only in the abdominal aorta. With regard to the radiation dose between the two groups, the total DLP was significantly higher in the TRO-CTAwAA group than in the conventional TRO-CTA group (P<0.001). The two groups did not significantly differ in scanning time (P=0.410). 【Conclusion】 TRO-CTA with scan range including the abdominal aorta significantly improves the detection rate for major vessel abnormalities in patients with chest pain without increasing the examination process.