Contrast Enhancement in Cardiac MDCT: Comparison of Iodixanol 320 Versus Iohexol 350
I-Chen Tsai1,2,3,4,
Tain Lee1,2,3,
Wei-Lin Tsai1,2,3,4,
Min-Chi Chen1,
Ming-Ju Wu4,5,
Wen-Lieng Lee3,4,6 and
Hui-Ju Ting7
1 Department of Radiology, 407, Taichung Veterans General Hospital, No. 160,
Section 3, Taichung Harbor Rd., Taichung, Taiwan, ROC.
2 Faculty of Medicine, Medical College of Chung Shan Medical University, Taiwan,
ROC.
3 Department of Medicine, National Yang Ming University, Taiwan, ROC.
4 Institute of Clinical Medicine, National Yang Ming University, Taiwan,
ROC.
5 Department of Nephrology, Taichung Veterans General Hospital, Taichung,
Taiwan, ROC.
6 Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan,
ROC.
7 Department of Applied Foreign Languages, Overseas Chinese Institute of
Technology, Taiwan, ROC.
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Fig. 1A —Right heart bolus geometry measurements in Hounsfield units (H)
during arterial phase in 56-year-old man. Using 70% R-R interval reconstructed
images with slice thickness and interval of 5 mm, right heart measurements are
performed. Av = average. At start of scanning, region of interest (ROI) is
placed in superior vena cava with size of ROI approximately half of diameter
of measured target. Measurements are done at every second of scanning.
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Fig. 1B —Right heart bolus geometry measurements in Hounsfield units (H)
during arterial phase in 56-year-old man. Using 70% R-R interval reconstructed
images with slice thickness and interval of 5 mm, right heart measurements are
performed. Av = average. While scanning continues, ROI is placed in right
atrium (B and C).
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Fig. 1C —Right heart bolus geometry measurements in Hounsfield units (H)
during arterial phase in 56-year-old man. Using 70% R-R interval reconstructed
images with slice thickness and interval of 5 mm, right heart measurements are
performed. Av = average. While scanning continues, ROI is placed in right
atrium (B and C).
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Fig. 1D —Right heart bolus geometry measurements in Hounsfield units (H)
during arterial phase in 56-year-old man. Using 70% R-R interval reconstructed
images with slice thickness and interval of 5 mm, right heart measurements are
performed. Av = average. Toward end of scanning, ROI is placed in right
ventricle. Please note that measurements must avoid prominent trabeculation in
right ventricular apex.
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Fig. 2A —Left heart bolus geometry measurements in Hounsfield units (H)
during arterial phase in 56-year-old man. Using 70% R-R interval reconstructed
images with slice thickness and interval of 5 mm, left heart measurements are
performed. Av = average. At start of scanning, region of interest (ROI) is
placed in ascending aorta, with size of ROI approximately half of diameter of
measured target. Measurements are performed at every second of scan.
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Fig. 2B —Left heart bolus geometry measurements in Hounsfield units (H)
during arterial phase in 56-year-old man. Using 70% R-R interval reconstructed
images with slice thickness and interval of 5 mm, left heart measurements are
performed. Av = average. While scanning continues, ROI is placed in aortic
root; aortic valve should be avoided.
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Fig. 2C —Left heart bolus geometry measurements in Hounsfield units (H)
during arterial phase in 56-year-old man. Using 70% R-R interval reconstructed
images with slice thickness and interval of 5 mm, left heart measurements are
performed. Av = average. While scanning continues, ROI is placed in left
ventricular outflow tract.
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Fig. 2D —Left heart bolus geometry measurements in Hounsfield units (H)
during arterial phase in 56-year-old man. Using 70% R-R interval reconstructed
images with slice thickness and interval of 5 mm, left heart measurements are
performed. Av = average. Toward end of scanning, ROI is placed in left
ventricle. Measurement must avoid papillary muscle.
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Fig. 3 —Oblique coronal reformatted image in 56-year-old man shows
"path" of regions of interest in z-axis. Right heart
bolus geometry (white dashed arrow) is passing through superior vena
cava, right atrium to right ventricle. Left heart bolus geometry (black
arrow) is passing through ascending aorta, aortic root, left ventricular
outflow tract, and left ventricle.
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Fig. 4A —Coronary artery enhancement measurements in Hounsfield units (H) in
56-year-old man obtained using 3-mm maximum-intensity projection images of
most quiescent phase. Av = average. Regions of interest (ROIs) are placed in
left main coronary artery, proximal left anterior descending artery, and
proximal circumflex coronary artery.
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Fig. 4B —Coronary artery enhancement measurements in Hounsfield units (H) in
56-year-old man obtained using 3-mm maximum-intensity projection images of
most quiescent phase. Av = average. In lower level, ROI is placed in proximal
right coronary artery.
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Fig. 5A —Myocardium measurements in Hounsfield units (H) in 56-year-old man.
Av = average. Using data set of 70% R-R interval thin-section images of
arterial phase, short axis at midventricular level is reformatted with 5-mm
average slab rendering. Measurements are done in left ventricular (LV) cavity
and four directions of LV myocardium.
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Fig. 5B —Myocardium measurements in Hounsfield units (H) in 56-year-old man.
Av = average. Using data set of 70% R-R interval thin-section images of
delayed phase, short axis at midventricular level is reformatted with 5-mm
average slab rendering. Measurements are done in LV cavity and four directions
of LV myocardium.
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Fig. 6 —Right heart bolus geometry comparison. From left to right, bar
represents enhancement in right heart at every second of scanning. It shows
exponential descending curve. Comparisons at every second between two groups
show no statistical difference.
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Fig. 7 —Left heart bolus geometry comparison. From left to right, bar
represents enhancement in left heart in every second of scanning. Generally,
left heart bolus geometry is high and homogeneous. Comparisons at every second
between two groups show no statistical difference.
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Fig. 8 —Myocardial enhancement change from arterial to delayed phase. Figure
shows myocardial enhancement change of both groups of patients. In arterial
phase, iohexol shows higher enhancement than iodixanol, although not
significantly higher. However, in delayed phase, iodixanol shows statistically
higher persistent enhancement (7.7 H) than iohexol.
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Copyright © 2008 by the American Roentgen Ray Society.
