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AJR 2000; 174:67-69
© American Roentgen Ray Society


Technical Innovation

Optimization of Combined CT Pulmonary Angiography with Lower Extremity CT Venography

David F. Yankelevitz1, Gordon Gamsu1, Ami Shah1, Jurgen Rademaker1,2, Dorith Shaham1,3, Natasha Buckshee1, Matthew D. Cham1 and Claudia I. Henschke1

1 Department of Radiology, New York Presbyterian Hospital—Weill Cornell Medical Center, 525 E. 68th St., New York, NY 10023

OBJECTIVE. We wanted to determine the time delay for maximum enhancement of the deep venous system of the lower extremities after standard CT pulmonary angiography.

SUBJECTS AND METHODS. In 20 patients who had undergone standard CT pulmonary angiography, we measured arterial and venous enhancement at the level of the greater trochanter. These measurements were obtained at 30-sec intervals immediately after completion of CT pulmonary angiography. Ten measurements were obtained in 5 min. Time—density curves were plotted.

RESULTS. We found that the median and average peak venous enhancements were 92 and 95 H, respectively. Time to peak enhancement was variable. Because of the broad shape of the venous time—density curve, near peak enhancement could be achieved in most patients at 2 min after CT pulmonary angiography.

CONCLUSION. CT of the deep venous system of the lower extremities after standard CT pulmonary angiography, performed with appropriate timing considerations, allows near maximal enhancement of the venous system in most patients without altering the optimum CT pulmonary angiography protocol.


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