Diagnostische Möglichkeiten von Multislice-CT und MRT bei Patienten mit akutem Thoraxschmerz

Kernaussagen

• Der akute Thoraxschmerz gehört zu den häufigsten Aufnahmediagnosen in Deutschland und erfordert eine schnelle Abklärung der umfangreichen Differenzialdiagnosen.

• Die bildgebende Diagnostik spielt in der Differenzierung zwischen kardial und nicht kardial bedingtem Thoraxschmerz eine zentrale Rolle.

• Bei kardial bedingtem akutem Thoraxschmerz gibt es bisher wenig Erfahrung mit dem Einsatz der kardialen MRT und der neueren Generationen der Mehrzeilen-CT.

• Das Potenzial der MRT und MSCT in der kardialen Diagnostik, in Ergänzung zu der bereits etablierten Indikation bei Verdacht auf nicht kardial bedingten akuten Throaxschmerz, hat dazu geführt, dass sog. Chest Pain Units geschaffen werden, in denen eine schnelle diagnostische Abklärung der Differenzialdiagnostik erfolgt. Prospektive Studien werden zeigen müssen, ob die ersten positiven Erfahrungen dieses Konzepts in der Praxis Bestand haben.

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