R J Oudiz1, M J Budoff, B H Brundage. 1. Harbor-UCLA Medical Center, Saint John's Cardiovascular Research Institute, Torrance, California 90502, USA. oudiz@humc.edu
Abstract
PURPOSE: There is considerable literature published on noninvasive contrast-enhanced techniques to diagnose pulmonary vascular abnormalities, however little data exists on the safety of contrast injections in patients with elevated pulmonary arterial pressures. We studied the safety of contrast-enhanced electron beam computed tomography (EBCT) in 29 patients with severe pulmonary hypertension. The mean dose of intravenous contrast used was 124 +/- 39 cc. MATERIALS AND METHODS: Subjects underwent EBCT using contrast injected at a rate of 2-4 ml/s. All patients were watched closely for at least 15 min post-procedure prior to being released. Patients had Doppler echocardiograms to estimate pulmonary artery pressure. Right heart catheterization data was collected for patients in which echocardiographic data was unavailable. RESULTS: A total of 29 patients with pulmonary arterial hypertension were studied. There were 17 patients with primary pulmonary hypertension (PPH), and 12 patients with secondary forms of pulmonary hypertension. None of the patients developed complications from their study. CONCLUSION: There is a paucity of data on the safety of contrast injections in patients with severely elevated pulmonary arterial pressures. Contrast-enhanced EBCT was well-tolerated in our diverse series of patients with severely elevated pulmonary arterial pressures. Clinicians concerned about invasive pulmonary angiography should consider contrast-enhanced EBCT as a safe alternative to angiography.
PURPOSE: There is considerable literature published on noninvasive contrast-enhanced techniques to diagnose pulmonary vascular abnormalities, however little data exists on the safety of contrast injections in patients with elevated pulmonary arterial pressures. We studied the safety of contrast-enhanced electron beam computed tomography (EBCT) in 29 patients with severe pulmonary hypertension. The mean dose of intravenous contrast used was 124 +/- 39 cc. MATERIALS AND METHODS: Subjects underwent EBCT using contrast injected at a rate of 2-4 ml/s. All patients were watched closely for at least 15 min post-procedure prior to being released. Patients had Doppler echocardiograms to estimate pulmonary artery pressure. Right heart catheterization data was collected for patients in which echocardiographic data was unavailable. RESULTS: A total of 29 patients with pulmonary arterial hypertension were studied. There were 17 patients with primary pulmonary hypertension (PPH), and 12 patients with secondary forms of pulmonary hypertension. None of the patients developed complications from their study. CONCLUSION: There is a paucity of data on the safety of contrast injections in patients with severely elevated pulmonary arterial pressures. Contrast-enhanced EBCT was well-tolerated in our diverse series of patients with severely elevated pulmonary arterial pressures. Clinicians concerned about invasive pulmonary angiography should consider contrast-enhanced EBCT as a safe alternative to angiography.
Authors: J R Mayo; M Remy-Jardin; N L Müller; J Remy; D F Worsley; C Hossein-Foucher; J S Kwong; M J Brown Journal: Radiology Date: 1997-11 Impact factor: 11.105
Authors: L R Goodman; J J Curtin; M W Mewissen; W D Foley; R J Lipchik; M R Crain; K B Sagar; B D Collier Journal: AJR Am J Roentgenol Date: 1995-06 Impact factor: 3.959