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Cardiac 16-MDCT for Anatomic and Functional Analysis: Assessment of a Biphasic Contrast Injection Protocol

Daisuke Utsunomiya1,2, Kazuo Awai2, Takashi Sakamoto1, Taiji Nishiharu1, Joji Urata1, Akira Taniguchi3, Takeshi Nakaura2 and Yasuyuki Yamashita2

1 Diagnostic Imaging Center, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Kumamoto-shi, Kumamoto 861-4193, Japan.
2 Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
3 CT Systems Division, Toshiba Medical Systems, Tokyo, Japan.


Figure 1
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  		Fig. 1 —Schematic of three contrast injection protocols.

 

Figure 2
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  		Fig. 2 —Graph shows left ventricular-myocardial contrast-to-noise ratio (CNR) profile along z-axis with each protocol. Each profile shows constant level during CT. Circular regions of interest (ROIs) were placed in left ventricular cavity and septal myocardial wall from most cranial (ROI 1) to most caudal (ROI 6) position in each patient.

 

Figure 3
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  		Fig. 3 —Graph shows right ventricular-myocardial contrast-to-noise ratio (CNR) profile along z-axis with each protocol. Profile obtained with protocol A shows more constant level, whereas profiles obtained with protocols B and C show decrease at caudal levels in right ventricle. Circular regions of interest (ROIs) were placed in right ventricular cavity and septal myocardial wall from most cranial (ROI 1) to most caudal (ROI 6) position in each patient.

 

Figure 4
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  		Fig. 4 —70-year-old man with angina pectoris. Transaxial CT image obtained with protocol A shows left ventricular endocardial and right ventricular septal endocardial contours are clearly delineated.

 

Figure 5
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  		Fig. 5A —68-year-old man with angina pectoris. Transaxial CT images obtained with protocol B show right ventricular septal endocardial contour is indistinguishable (arrows, B).

 

Figure 6
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  		Fig. 5B —68-year-old man with angina pectoris. Transaxial CT images obtained with protocol B show right ventricular septal endocardial contour is indistinguishable (arrows, B).

 

Figure 7
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  		Fig. 6A —Time-density curves. PA = pulmonary artery. Graph shows time-density curve for protocol A. Adequate and uniform attenuation is present in both aorta and pulmonary artery 20-50 seconds after start of contrast injection.

 

Figure 8
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  		Fig. 6B —Time-density curves. PA = pulmonary artery. Graph shows time-density curve for protocol B.

 

Figure 9
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  		Fig. 6C —Time-density curves. PA = pulmonary artery. Graph shows time-density curve for protocol C.

 

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