Heliyon (Dec 2024)
Optimizing acute chest pain diagnosis: Efficacy of 64-channel multi-slice CT with Snap-Shot Freeze technique in Triple-Rule-out CT angiographyKey Points
Abstract
Objective: This study evaluates the efficacy of Snap-Shot Freeze (SSF) technology combined with optimized contrast medium (CM) injection protocols in Triple-Rule-Out (TRO) computed tomography angiography (CTA) using 64-channel multi-slice CT (MSCT) for diagnosing acute chest pain (ACP). Materials and methods: A total of 111 patients presenting with ACP were enrolled and divided into two groups: Group 1 (23 patients) underwent TRO CTA using 64-channel MSCT with SSF technology, while the control group (88 patients) which was further divided into three cohorts underwent specific site CTA scans. Quantitative metrics such as CT values, standard deviation (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated for pulmonary artery, coronary arteries, and aortic imaging. Demographic characteristics, image qualification rate and disease diagnosis rate of groups 1–4 were also evaluated. Qualitative evaluations were based on a 5-point scoring system assessing overall image quality, vessel clarity, and artifact presence. Radiation doses were measured in terms of CT dose index volume (CTDIvol), dose length product (DLP), and effective dose (ED). Results: The demographic characteristics of the patients showed no significant differences in age, BMI, or resting heart rate between Group 1 and the control group. The image qualification rate was 100 % for both groups, with excellent rates of 89.13 % in Group 1 and 85.67 % in the control group. No significant differences were found in average CT values, standard deviation (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) between Group 1 and the control group for pulmonary artery (e.g., PT: 394.25 ± 124.19 vs 383.64 ± 115.72 HU, p = 0.74), coronary artery (e.g., AA: 483.71 ± 115.62 vs 493.95 ± 138.54 HU, p = 0.79), and aorta (e.g., AAo: 325.1 ± 99.39 vs 348.98 ± 74.23 HU, p = 0.34). Qualitative image quality scores and radiation doses were also comparable (e.g., ED: 28.36 ± 12.6 vs 29.97 ± 10.36 mSv, p = 0.77). Qualitative assessments also revealed comparable image quality scores between the two groups (4.5 ± 0.5 vs 4.3 ± 0.6). The total volume of iodinated CM was significantly reduced in Group 1 (66 mL vs 227 mL). Conclusion: The use of 64-channel MSCT combined with SSF technology in TRO CTA provides noninferior high-quality imaging comparable to traditional specific site CTA, with the added benefits of reduced CM volume and shorter examination times. This approach is effective for the comprehensive evaluation of ACP in clinical practice.
