Akut Göğüs Ağrısı ile Acil Servise Başvuran Hastaların Çift Tüplü Bilgisayarlı Tomografi Cihazı ile Triple Rule-out Tomografi Anjiografilerinin Değerlendirilmesi

Yıl 2019, Cilt: 4 Sayı: 1, 12 - 20, 01.04.2019

Feyzi Özçınar Türkan İkizceli Tuba Selçuk Can

Öz

Amaç: Bu çalışmada tek bir
çekimle, kısa sürede göğüs ağrısına sebep olabilecek koroner, aortik ya da
pulmoner sebeplerin saptanmasında Triple rule-out (TRO) tomografik anjiyografi tekniği
uygulanarak, çift tüplü bilgisayarlı tomografi (dual source computerise
tomography, çift tüplü bilgisayarlı tomografi, ÇTBT) incelemelerinin etkinliğini
ve olası kısıtlılıklarını değerlendirmeyi amaçladık.

Materyal ve Metod: Çalışmaya Ekim 2011-Kasım 2012 tarihleri
arasında akut göğüs ağrısı ile acile başvuran, akut koroner sendrom (AKS), akut
pulmoner tromboemboli (PTE) ve aort diseksiyonundan en az biri ön tanı olarak
düşünülen TRO tekniği uygulanarak ÇTBT çekimi uygulanmış olan 154 hasta (102
erkek, 52 kadın; yaş ortalaması: 58,21±13.22) dahil edildi.  Hastalara ait görüntülerde axiyel kesitler, multi-planar
reformat (MPR), curved MPR, maximum intensity projeksiyon (MIP) ve volume
rendering (VR) imajlar kullanılarak değerlendirme yapıldı.

Bulgular: 154 hastanın 108
(%70,12)'inde koroner arterlerin incelenmesi neticesinde koroner arter hastalığı
(KAH) tespit edildi. Bu 108 hastanın ise 36 (%23,37)'sında hafif, 42
(%27,27)'sinde orta ve 30 (%19,48)'unda ileri derecede KAH mevcuttu. Bunun
yanında hastaların 21 (%13,63)'inde PTE saptandı. Hastaların 8(%5,1)'inde aort
diseksiyonu, 1 (%0,6)'inde ise aort koarktasyonu bulundu.

Sonuç: TRO-ÇTBT, kısa çekim
süresi ve tek bir çekimle çok sayıda patolojinin ekartasyonunu sağlayan, erken
tanı ve tedavi ile gereksiz maliyetleri ortadan kaldıran güvenilir non-invaziv bir
tanı yöntemidir.

Anahtar Kelimeler

triple rule-out, bilgisayarlı tomografik anjiografi, çift tüplü bilgisayarlı tomografi, akut göğüs ağrısı

Kaynakça

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