Literature DB >> 23196833

Carbon dioxide-contrasted computed tomography angiography: high pitch protocols and adapted injection parameters improve imaging quality.

T Penzkofer1, K Slebocki, J Grommes, P Bruners, P P Isfort, N Heussen, T Schmitz-Rode, C K Kuhl, S Langer, A H Mahnken.   

Abstract

PURPOSE: To systematically investigate the impact of image acquisition and contrast injection parameters for CO2-enhanced CT angiography (CTA) of the aorto-iliac and peripheral arteries in a pig model using commercially available equipment. The aim was to establish an imaging protocol that is ready for use in human subjects.
MATERIALS AND METHODS: Three domestic swine underwent CO2-CTA with varying injection parameters: pitch (1.0, 3.0), injection pressure (0.7 bar, 1.0 bar, 1.3 bar) and scan delay (2 s, 4 s, 6 s). Objective (vessel diameter) and subjective (image quality) parameters and applied radiation doses were systematically evaluated. To ensure clinical applicability of the setting, only approved catheters/injectors and standard injection parameters were evaluated.
RESULTS: The image quality scores were superior and the vessel diameter was larger with high pitch in comparison to standard pitch (diameters: 4.7 ± 2.0 mm vs. 3.6 ± 2.1 mm, p = 0.0040, scores: 2.6 ± 1.1 vs. 2.0 ± 1.1, p = 0.0038). High injection pressure (1.3 bar) improved the image quality as assessed by subjective and objective ratings (diameters: 3.6 ± 2.0 mm, 4.0 ± 2.1 mm and 4.6 ± 2.1 mm, for 0.7, 1.0 and 1.3 bar, p-values ≤ 0.0052, scores: 1.9 ± 1.1, 2.3 ± 1.1 and 2.7 ± 1.2, p-values ≤ 0.0017), the same was observed for a shorter injection delay (diameters: 3.5 ± 2.0 mm, 4.2 ± 2.1 mm and 4.8 ± 2.1 mm, for 6 s, 4 s, and 2 s, p ≤ 0.0022, scores: 1.9 ± 1.1, 2.3 ± 1.1 and 2.7 ± 1.1, p-values ≤ 0.0013). The dose length products were 239 ± 47 mGycm (high pitch) and 565 ± 63 mGycm (standard pitch, p-values < 0.0001).
CONCLUSION: A higher pitch, shorter delay and higher injection pressure improve image quality in CO2-enhanced CTA. Since commercially available, clinically approved equipment was used. The protocol is now ready for use in human subjects. © Georg Thieme Verlag KG Stuttgart · New York.

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Year:  2012        PMID: 23196833     DOI: 10.1055/s-0032-1325603

Source DB:  PubMed          Journal:  Rofo        ISSN: 1438-9010


  2 in total

1.  Peripheral diagnostic and interventional procedures using an automated injection system for carbon dioxide (CO2): case series and learning curve.

Authors:  Arturo Giordano; Stefano Messina; Michele Polimeno; Nicola Corcione; Paolo Ferraro; Giuseppe Biondi-Zoccai; Gabriele Giordano
Journal:  Heart Lung Vessel       Date:  2015

Review 2.  Use of carbon dioxide as an intravascular contrast agent: A review of current literature.

Authors:  Fahad Ali; Muhammad Asif Mangi; Hiba Rehman; Edo Kaluski
Journal:  World J Cardiol       Date:  2017-09-26
  2 in total

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