[Possibilities for exposure reduction in computed tomography examination of acute chest pain].

CLINICAL/METHODICAL ISSUE: Electrocardiogram-gated (ECG) computed tomography (CT) investigations can be accompanied by high amounts of radiation exposure. This is particularly true for the investigation of patients with unclear and acute chest pain. STANDARD RADIOLOGICAL
METHODS: The common approach in patients with acute chest pain is standard spiral CT of the chest. METHODICAL INNOVATIONS: The chest pain or triple-rule-out CT protocol is a relatively new ECG-gated protocol of the entire chest. This article reviews and discusses different techniques for the CT investigation of patients with acute chest pain. PERFORMANCE: By applying the appropriate scan technique, the radiation exposure for an ECG-gated protocol must not necessarily be higher than a standard chest CT scan ACHIEVEMENTS: Aortic pathologies are far better depicted by ECG-gated scan protocols and depending on the heart rate coronary artery disease can also be detected at the same time. PRACTICAL RECOMMENDATIONS: The use of ECG-triggered scans will not support the diagnostics of the pulmonary arteries. However, in unspecific chest pain an ECG-triggered scan protocol can provide information on the differential diagnosis.