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Keywords:
Cardiac, Cardiovascular system, CT-Angiography, Comparative studies, Arteriosclerosis
Authors:
H. Nebelung, I. Platzek, U. Speiser, T. Brauer, M. Laniado, R. Strasser; Dresden/DE
DOI:
10.1594/ecr2017/C-2833
Conclusion
Bolus tracking in the left atrium (Fig. 1 - A),
as in triple-rule-out CTA,
does not adversely affect depiction of the coronary arteries if compared to conventional bolus tracking in the ascending aorta (Fig. 1 - B).
This result is a further argument for an extension of the indication for triple-rule-out CT angiography in place of conventional CCTA in patients with acute thoracic pain,
because despite the additional depiction of the pulmonary arteries and the thoracic aorta,
the depiction of the coronary arteries is not restricted.
Limitations:
A significant limitation of this work is the lack of correlation with digital subtraction angiography (DSA),
which still represents the gold standard for the diagnosis of coronary heart disease.
In order to be able to compare these two diagnostic methods,
further studies would be necessary.
A further limitation is the retrospective study design,
that impedes the detection of causality.
Nevertheless,
it can provide empirical evidence to support hypotheses.
Moreover,
the use of propensity score matching is a limitation of the study,
because interpersonal differences cannot be completely eliminated by that method.
Furthermore,
the study was limited by the use of only 50 ml of contrast medium instead of the usual 80 ml or 100 ml,
which were necessary for examinations with older device generations.
This makes comparability with computed tomography systems of older generations more difficult.