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Thoracoabdominal-Aortoiliac MDCT Angiography Using Reduced Dose of Contrast Material

¹ Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University Graduate School of Medicine, Kyoto, Japan.
² Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215.
³ Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁴ Present address: Division of Cardiology, Kitano Hospital, Tadukekofukai Medical Research Institute, Osaka, Japan.
⁵ Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.

OBJECTIVE. The objective of our study was to compare the image quality of MDCT angiography studies obtained by injection of low doses of contrast medium with saline flush versus conventional doses of contrast medium.

MATERIALS AND METHODS. Seventy-one patients with pre- or postoperative aortic aneurysms underwent MDCT angiography throughout the thoracoabdominal-aortoiliac system using an 8-MDCT scanner. In 37 patients, 100 mL of contrast medium was injected at a flow rate of 3.0 mL/s (hereafter referred to as the 100-mL group). In 34 patients, 50 mL of contrast medium followed by a 20-mL saline flush was injected at a flow rate of 2.5 mL/s (the 50-mL group). For each group, quantitative analysis involved calculating the mean aortoiliac enhancement, plateau deviation, and contrast enhancement in the pulmonary trunk and superior vena cava (SVC). Qualitative analysis involved assessing the 3D postprocessing images.

RESULTS. Significant differences between the groups in mean aortoiliac enhancement (100-mL group vs 50-mL group, 337 ± 6 H vs 319 ± 5 H, p < 0.0001) and mean plateau deviation (51 ± 4 H vs 58 ± 4 H, p < 0.0001) were found. However, adequate arterial enhancement ( 200 H) was observed in 31 of 34 patients in the 50-mL group and uniform aortoiliac enhancement (< 50 H) was seen in 26 patients. Visual analysis showed no difference in contrast material magnitude and homogeneity between the groups. Furthermore, in the 50-mL group, the thoracic aorta was more clearly visualized because of a reduction in the opacity of the main pulmonary artery and SVC.

CONCLUSION. In our experience, administration of 50 mL of contrast medium followed by a 20-mL saline flush produces thoracoabdominal-aortoiliac MDCT angiographic examinations of effective quality in most cases.

Keywords: cardiovascular imaging • contrast media • saline flush • MDCT angiography

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