急性胸痛病人的分拣仍然是一挑战。病人的病史、最初心肌酶的水平或初始心电图(ECG)往往无法分拣出需要进一步检查的病人。须考虑到许多血管和非血管胸部问题如肺栓塞(PE)、主动脉夹层或急性冠状动脉综合征,以及肺、胸膜或骨病变。如今临床提出可疑PE或急性主动脉综合征时,增强多层CT已经取代了以往的有创性诊断程序,成为具有代表性的可选成像方式。同时,CT检查能够检测多种非血管原因急性胸痛,如肺炎、心包炎或骨折。 Acute chest pain patients sorting is still a challenge. The patient’s medical history, initial myocardial enzyme levels, or initial electrocardiogram (ECG) often fail to sort out patients in need of further examination. Many vascular and non-vascular thoracic problems such as pulmonary embolism (PE), aortic dissection or acute coronary syndrome, and lung, pleural or bone lesions must be considered. Nowadays, when clinical suspicious PE or acute aortic syndrome is proposed, enhanced multi-slice CT has replaced the previous invasive diagnostic procedures and become a representative alternative imaging method. At the same time, CT can detect a variety of non-vascular causes of acute chest pain, such as pneumonia, pericarditis or fractures.