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Computed tomography pulmonary angiography and venography with a low dose of contrast medium

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Abstract

The authors developed a method to ensure sufficient opacification of pulmonary vasculature for separate depiction of arteries and veins in three-dimensional form with a small dose of contrast medium utilizing a test injection to determine optimal timing of computed tomography (CT) scanning. The dose was determined by a simulation based on a pharmacokinetic model. The contrast medium was administered at a rate of 5.0 mL/s for 3 s, followed by helical scanning at the timing determined by a dynamic CT scanning following the test injection. Images of 20 consecutive patients acquired with a 64-row CT scanner were evaluated. Quality of vessel depiction was assessed on the basis of the following: HU values at the main pulmonary artery (MPA) and left atrium (LA), distance between the pleural surface and the distal end of the pulmonary vessels on three-dimensional CT pulmonary arteriography and venography (3D-CTPAV), and subjective visual assessment of quality of the 3D-CTPAV images. Time to generate the 3D-CTPAV images was recorded. The mean ± standard deviation (SD) of the HU values at MPA/LA and the distances to the pleural surface for pulmonary arteries/veins were 448.0 ± 123.1/277.3 ± 60.85 HU and 9.21 ± 3.60/10.7 ± 5.45 mm, respectively. The image quality was visually rated as excellent for all of the patients. The mean time ± SD to generate 3D-CTPAV images was 13.6 ± 6.7 min. In conclusion, three-dimensional images of the pulmonary vasculature can be created using 21 mL (including 6 mL for the test injection) of contrast medium.

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Authors and Affiliations

  1. Radiology Service, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan

    Jun Nakane

  2. Radiology Service, Division of Nuclear Medicine, Saitama Sekishinkai Hospital, 2-37-20, Irumagawa, Sayama, Saitama, 350-1305, Japan

    Norinari Honda

  3. Department of Radiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan

    Kazuhiro Tsuchiya

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  1. Jun Nakane
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  2. Norinari Honda
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  3. Kazuhiro Tsuchiya
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Correspondence to Jun Nakane.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies performed in animals.

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Informed consent was obtained from all the study participants.

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Nakane, J., Honda, N. & Tsuchiya, K. Computed tomography pulmonary angiography and venography with a low dose of contrast medium. Radiol Phys Technol 12, 61–68 (2019). https://doi.org/10.1007/s12194-018-00492-5

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  • DOI: https://doi.org/10.1007/s12194-018-00492-5

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