Statement from the Clinical Imaging Board on the use of ECG gating in CT imaging of the thoracic aorta

CIB Position Statement


Imaging of the thoracic aorta with CT is a common investigation performed in the elective and emergency settings. In acute and emergency care, it is used to identify or exclude potentially life-threatening conditions such as acute aortic syndromes, including aortic dissection.

The pulsatile nature of the aorta means that motion artefacts on imaging can make assessment extremely difficult. However, ECG gating is a well-established technique in cross sectional imaging and enables the moving structures in the thorax to be imaged effectively motion-free by coordinating scan acquisition with the patient’s heartbeat(1). Most modern CT scanners have this capability.

The Clinical Imaging Board supports the routine use of ECG gating in all patients undergoing thoracic aortic CT 24/7 , in and out of hours. While it is acknowledged that there will be a need for a programme of training in imaging departments, this is considered best practice and will help ensure optimal patient care and safety.

  1. Vardhanabhuti V, Nicol E, Morgan-Hughes G, Roobottom CA, Roditi G, Hamilton MC, Bull RK, Pugliese F, Williams MC, Stirrup J, Padley S, Taylor A, Davies LC, Bury R, Harden S. 
    Recommendations for accurate CT diagnosis of suspected acute aortic syndrome (AAS)--on behalf of the British Society of Cardiovascular Imaging (BSCI)/British Society of Cardiovascular CT (BSCCT). 
    Br J Radiol. 2016;89(1061):20150705. doi: 10.1259/bjr.20150705. Epub 2016 Feb 26. PMID: 26916280; PMCID: PMC4985448.