caa a22 4500 606171150 CHVBK 20210128100721.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10140-014-1239-8 doi (NATIONALLICENCE)springer-10.1007/s10140-014-1239-8 Can non-contrast-enhanced CT (NECT) triage patients suspected of having non-traumatic acute aortic syndromes (AAS)? [Elektronische Daten] [Paul Vantine, Jessica Rosenblum, William Schaeffer, Kevin Williams, David Dockray, Jeffrey Levsky, Linda Haramati, Loren Ketai] This work was conducted to determine whether non-contrast-enhanced CT (NECT) of patients with suspected acute aortic syndrome (AAS) can identify patients with a very low likelihood of a positive diagnosis. In the derivation phase, patients who received both NECT and contrast-enhanced CT angiography (CTA) for suspected AAS were identified. Two readers blinded to CTA results analyzed NECTs from AAS positive and negative cases, recording maximal aortic diameters and qualitative findings of aortic disease. Logistic regression analysis was performed to identify independent positive predictors for AAS; those predictors were then used to create a decision rule. For the validation phase, NECTs from patients evaluated for AAS at a second institution were reviewed by two independent readers who recorded the presence of decision rule predictors while blinded to CTA results. In the derivation phase, 34 CTA positive and 83 CTA negative cases were reviewed. Measurements of aortic diameter alone achieved mean sensitivity and specificity of 82% and of 83%, respectively. Logistic regression identified aortic diameter, displaced calcifications, high attenuation aortic wall and abnormal aortic contour as independent predictors of AAS. The decision rule incorporating these findings achieved higher mean sensitivity (93%), negative predictive value (96%), and moderate reader agreement (kappa = 0.59). For the validation phase, application of the decision rule to 35 AAS positive and 45 AAS negative cases at the second institution yielded sensitivity of 100% and specificity of 74% for both readers. NECT can identify patients with a very low likelihood of AAS and potentially mitigate the urgency of performing CTA. Am Soc Emergency Radiol, 2014 Acute aortic syndrome nationallicence Non-contrast CT nationallicence Triage nationallicence Clinical decision rule nationallicence Vantine Paul Department of Radiology, University of New Mexico Health Science Center, MSC10 5530, 1 University of New Mexico, 87131-0001, Albuquerque, NM, USA aut Rosenblum Jessica Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th St. Gold Zone, 10467, Bronx, NY, USA aut Schaeffer William Department of Radiology, University of New Mexico Health Science Center, MSC10 5530, 1 University of New Mexico, 87131-0001, Albuquerque, NM, USA aut Williams Kevin Department of Radiology, University of New Mexico Health Science Center, MSC10 5530, 1 University of New Mexico, 87131-0001, Albuquerque, NM, USA aut Dockray David Department of Surgery, Abington Memorial Hospital, 1200 Old York Road, 19001, Abington, PA, USA aut Levsky Jeffrey Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th St. Gold Zone, 10467, Bronx, NY, USA aut Haramati Linda Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th St. Gold Zone, 10467, Bronx, NY, USA aut Ketai Loren Department of Radiology, University of New Mexico Health Science Center, MSC10 5530, 1 University of New Mexico, 87131-0001, Albuquerque, NM, USA aut Emergency Radiology Springer Berlin Heidelberg 22/1(2015-02-01), 19-24 1070-3004 22:1<19 2015 22 10140 https://doi.org/10.1007/s10140-014-1239-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10140-014-1239-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vantine Paul Department of Radiology, University of New Mexico Health Science Center, MSC10 5530, 1 University of New Mexico, 87131-0001, Albuquerque, NM, USA aut NATIONALLICENCE 700 1- Rosenblum Jessica Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th St. Gold Zone, 10467, Bronx, NY, USA aut NATIONALLICENCE 700 1- Schaeffer William Department of Radiology, University of New Mexico Health Science Center, MSC10 5530, 1 University of New Mexico, 87131-0001, Albuquerque, NM, USA aut NATIONALLICENCE 700 1- Williams Kevin Department of Radiology, University of New Mexico Health Science Center, MSC10 5530, 1 University of New Mexico, 87131-0001, Albuquerque, NM, USA aut NATIONALLICENCE 700 1- Dockray David Department of Surgery, Abington Memorial Hospital, 1200 Old York Road, 19001, Abington, PA, USA aut NATIONALLICENCE 700 1- Levsky Jeffrey Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th St. Gold Zone, 10467, Bronx, NY, USA aut NATIONALLICENCE 700 1- Haramati Linda Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th St. Gold Zone, 10467, Bronx, NY, USA aut NATIONALLICENCE 700 1- Ketai Loren Department of Radiology, University of New Mexico Health Science Center, MSC10 5530, 1 University of New Mexico, 87131-0001, Albuquerque, NM, USA aut NATIONALLICENCE 773 0- Emergency Radiology Springer Berlin Heidelberg 22/1(2015-02-01), 19-24 1070-3004 22:1<19 2015 22 10140