caa a22 4500 60622047X CHVBK 20210128101123.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s00380-013-0437-8 doi (NATIONALLICENCE)springer-10.1007/s00380-013-0437-8 Role of non-electrocardiogram-gated contrast-enhanced computed tomography in the diagnosis of acute coronary syndrome [Elektronische Daten] [Yoshinori Mano, Toshihisa Anzai, Akihiro Yoshizawa, Yuji Itabashi, Takahiro Ohki] Non-electrocardiogram-gated contrast-enhanced computed tomography (non-ECG-gated CT) is available in most hospitals where patients with chest and/or back pain are admitted to the emergency department. Although it has been established as the initial diagnostic imaging modality for acute aortic dissection (AAD) and pulmonary thromboembolism (PE), its diagnostic ability for acute coronary syndrome (ACS) in the emergency department has not been elucidated. We retrospectively investigated 154 consecutive patients who required non-ECG-gated CT to differentiate AAD and PE in the emergency department, but had no evidence of them on CT. Furthermore, a subanalysis was performed in the patients who were subsequently suspected of ACS and underwent emergent invasive coronary angiography followed by CT. We evaluated left ventricular enhancement to detect myocardial perfusion deficit by calculating Hounsfield units, and the results were compared with ultimate diagnoses and angiography findings. A perfusion deficit was detected in 43 patients, among whom 26 were ultimately diagnosed with acute myocardial infarction (AMI); 24 patients required emergent revascularization. The subanalysis indicated that perfusion abnormalities corresponded with the territory of the culprit artery in all except one patient. In the remaining 111 patients without perfusion deficit, only two required emergent revascularization, and their levels of creatine kinase MB were not elevated. The sensitivity, specificity, and positive and negative predictive values of non-ECG-gated CT in predicting AMI/emergent revascularization were 93 %, 87 %, 61 %, and 98 %/92 %, 85 %, 56 %, and 98 %, respectively. Non-ECG-gated CT facilitates the diagnosis of ACS and the decision on emergent catheterization, providing information on the ischemic myocardial area by detection of a localized decrease in left ventricular enhancement. Springer Japan, 2013 Acute coronary syndrome nationallicence Computed tomography nationallicence Perfusion deficit nationallicence Emergency department nationallicence Mano Yoshinori Department of Cardiology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, 272-8513, Ichikawa, Chiba, Japan aut Anzai Toshihisa Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan aut Yoshizawa Akihiro Department of Cardiology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, 272-8513, Ichikawa, Chiba, Japan aut Itabashi Yuji Department of Cardiology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, 272-8513, Ichikawa, Chiba, Japan aut Ohki Takahiro Department of Cardiology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, 272-8513, Ichikawa, Chiba, Japan aut Heart and Vessels Springer Japan 30/1(2015-01-01), 1-8 0910-8327 30:1<1 2015 30 380 https://doi.org/10.1007/s00380-013-0437-8 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/s00380-013-0437-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mano Yoshinori Department of Cardiology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, 272-8513, Ichikawa, Chiba, Japan aut NATIONALLICENCE 700 1- Anzai Toshihisa Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan aut NATIONALLICENCE 700 1- Yoshizawa Akihiro Department of Cardiology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, 272-8513, Ichikawa, Chiba, Japan aut NATIONALLICENCE 700 1- Itabashi Yuji Department of Cardiology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, 272-8513, Ichikawa, Chiba, Japan aut NATIONALLICENCE 700 1- Ohki Takahiro Department of Cardiology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, 272-8513, Ichikawa, Chiba, Japan aut NATIONALLICENCE 773 0- Heart and Vessels Springer Japan 30/1(2015-01-01), 1-8 0910-8327 30:1<1 2015 30 380