الفهرس 
o Anatomical considerations of the coronaries and great thoracic vesselsOnly 14 pages are availabe for public view
 |  | from | 70 |  |  |
| | | from | 70 | | |
Abstract
The correct decisions in patients suffering from chest pain remain a
challenge. The patient’s history, initial cardiac enzyme levels, or initial
electrocardiograms (ECG) often do not allow selecting the patients in
whom further tests are needed (Knowles et al., 2009).
Numerous vascular and non-vascular chest problems, such as
pulmonary embolism (PE), aortic dissection or acute coronary syndrome,
as well as pulmonary, pleural, or osseous lesions, must be taken into
account (Stillman et al., 2007).
Nowadays, contrast-enhanced multidetector-row computed tomography
(CT) has replaced previous invasive diagnostic procedures and currently represents
the imaging modality of choice when the clinical suspicion of pulmonary embolism
or acute aortic syndrome is raised (Butler and Swencki, 2006).
At the same time multidetector CT is capable of detecting a
multitude of non threatening causes of acute chest pain, such as
pneumonia, pericarditis, or fractures (Johonson et al., 2007).
Recent technical advances in CT technology have also shown great
advantages for non-invasive imaging of the coronary arteries (Miro et al.,
2010).
In patients with acute chest pain the optimization of decisions and
cost-effectiveness using cardiac CT in the emergency department have
been repetitively demonstrated (Frauenfelder et al., 2009).
Triple rule-out CT denominates an ECG-gated protocol that
allows for the depiction of the pulmonary arteries, thoracic aorta, and
coronary arteries within a single examination. This can be accomplished
through the use of a dedicated contrast media administration regimen
resulting in simultaneous attenuation of the three vessel territories (Savino
et al., 2006).