PURPOSE To compare different contrast material injection protocols using free breathing high-pitch dual-source pulmonary angiography in patients with suspected pulmonary embolism. METHOD AND MATERIALS Data of 50 consecutive patients refferred for CTPA for exclusion of PE were retrospectevely evaluated.All scans were performed on a 128-channel dual-source CT scanner (Somatom Definition Flash, Germany) with a high-pitch protocol ( pitch 3.0,100kV, 180mAs).In group 1 (n=20) contrast enhancement was achieved by injecting 1.5mLxkg of CM followed by a saline chaser of 50cc, and in group 2 contrast enhancement was achieved by means of a dose Iodine converter ( Bracco, italy) followed by a saline chaser of 50 cc. In all studies, Iomeron (400mg/ml) was used and injected at 4ml/sec. Attenuation profiles in the pulmonary trunk and on segmental levels were measured to evaluate the enhancement within the pulmonary arteries. Image quality and motion artifacts were assessed using a 3 degree scale ( 1-non-diagnostic), (2-poor), (3-sufficient). Statiscal analysis was performed by using the Wilcoxon test. RESULTS The amount of CM generated by the Dose Iodine Converter for reduced IV constrat dose ranged from 30 to 55 mL. In all patients an adequate and homogeneous contrast enhancement of more than 250 HU was achieved in the pulmonary arteries. No statiscally significant difference between group 1 and 2 was observed (p<0.05) regarding the attenuation of the pulmonary arteries. With regard to image quality and motion artifacts, all examinations were classified as sufficient. CONCLUSION A homogeneous opacitifaction of the pulmonary arteries and sufficient image quality partially free of motion artifacts due to breathing , can be achieved with reduced IV contrast dose in high pitch CT pulmonary angiography. CLINICAL RELEVANCE/APPLICATION High Pitch Dual Source CT pulmonary angiography is recommended for patients that are not able to hold their breath
High Pitch Dual Source CT Pulmonary Angiography with Reduced IV Contrast Dose and Free-Breathing / A. Lemos, J. Sternberg, U. Cioffi, R. Brambilla, P. Biondetti. ((Intervento presentato al 98. convegno RSNA 2012 - scientific assembly and annual meeting Chicago, november 25-30 th, 2012 tenutosi a Chicago nel 2012.
High Pitch Dual Source CT Pulmonary Angiography with Reduced IV Contrast Dose and Free-Breathing
U. Cioffi;
2012
Abstract
PURPOSE To compare different contrast material injection protocols using free breathing high-pitch dual-source pulmonary angiography in patients with suspected pulmonary embolism. METHOD AND MATERIALS Data of 50 consecutive patients refferred for CTPA for exclusion of PE were retrospectevely evaluated.All scans were performed on a 128-channel dual-source CT scanner (Somatom Definition Flash, Germany) with a high-pitch protocol ( pitch 3.0,100kV, 180mAs).In group 1 (n=20) contrast enhancement was achieved by injecting 1.5mLxkg of CM followed by a saline chaser of 50cc, and in group 2 contrast enhancement was achieved by means of a dose Iodine converter ( Bracco, italy) followed by a saline chaser of 50 cc. In all studies, Iomeron (400mg/ml) was used and injected at 4ml/sec. Attenuation profiles in the pulmonary trunk and on segmental levels were measured to evaluate the enhancement within the pulmonary arteries. Image quality and motion artifacts were assessed using a 3 degree scale ( 1-non-diagnostic), (2-poor), (3-sufficient). Statiscal analysis was performed by using the Wilcoxon test. RESULTS The amount of CM generated by the Dose Iodine Converter for reduced IV constrat dose ranged from 30 to 55 mL. In all patients an adequate and homogeneous contrast enhancement of more than 250 HU was achieved in the pulmonary arteries. No statiscally significant difference between group 1 and 2 was observed (p<0.05) regarding the attenuation of the pulmonary arteries. With regard to image quality and motion artifacts, all examinations were classified as sufficient. CONCLUSION A homogeneous opacitifaction of the pulmonary arteries and sufficient image quality partially free of motion artifacts due to breathing , can be achieved with reduced IV contrast dose in high pitch CT pulmonary angiography. CLINICAL RELEVANCE/APPLICATION High Pitch Dual Source CT pulmonary angiography is recommended for patients that are not able to hold their breath
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