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Optimisation of contrast medium volume and injection-related factors in CT pulmonary angiography: 64-slice CT study

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Abstract

Objective

To compare the image quality of computed tomography pulmonary angiography (CTPA) obtained with the injection of various low doses of contrast medium (CM) with different injection-related factors.

Methods

A total of 90 patients (42 females, 48 males; 54.3 ± 18.6 years) undergoing CTPA were included. Three CM protocols, each containing 30 patients, were created. Protocols 1, 2 and 3 consisted of a CM of 60 ml, 55 ml and 50 ml, and a bolus trigger level of 120 HU, 90 HU and 75 HU, respectively. Injection was uniphasic for protocols 1 and 2 (flow rate 5 ml/s), and biphasic for protocol 3 (flow rates 5 and 4 ml/s); with saline flushing afterwards. Enhancement was measured in three central and six peripheral pulmonary arteries.

Results

The mean attenuation value for pulmonary arteries was over 250 HU for all protocols. There was no difference between the attenuation levels with the protocols (p > 0.05). The percentage of pulmonary arteries exceeding optimal attenuation (≥250 HU) showed that protocols 2 and 3 were 90–100% successful (p < 0.05).

Conclusion

The use of proper injection-related factors during CTPA, such as a low trigger level and a high flow rate with saline injection following a decreased CM volume (55 ml or 50 ml), will enable adequate pulmonary artery contrast enhancement.

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Acknowledgements

This study was presented as a scientific exhibit at ECR 2010.

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Authors and Affiliations

  1. Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey

    Selma Uysal Ramadan, Pınar Kosar, Iclal Sonmez & Ugur Kosar

  2. Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Sevilay Karahan

  3. Ankara Training and Research Hospital, Fakulteler mah. Cemal Gursel cad.68/6, 06590, Cebeci, Ankara, Turkey

    Selma Uysal Ramadan

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  1. Selma Uysal Ramadan
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  2. Pınar Kosar
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  3. Iclal Sonmez
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  5. Ugur Kosar
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Correspondence to Selma Uysal Ramadan.

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Uysal Ramadan, S., Kosar, P., Sonmez, I. et al. Optimisation of contrast medium volume and injection-related factors in CT pulmonary angiography: 64-slice CT study. Eur Radiol 20, 2100–2107 (2010). https://doi.org/10.1007/s00330-010-1782-y

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  • DOI: https://doi.org/10.1007/s00330-010-1782-y

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