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Fig. 5D —69-year-old woman with suspected coronary artery disease. Images
show poor contrast enhancement. Contrast timing was good because coronary
arteries were already enhancing. Note poor enhancement of left ventricle (LV),
which should be brightly enhanced (B) (compare with
Fig. 4). Also note stent in
circumflex coronary artery (A and C), where artery is moderately
enhanced. Patient performed Valsalva maneuver during image acquisition that is
recognized by contrast column with convex shape toward superior vena cava (SVC
on coronal image, D), whereas saline flush should be running through at
this time point. High intrathoracic pressure during Valsalva maneuver hampers
inflow in right atrium and causes poor contrast enhancement. Mean heart rate
was 77 beats per minute. R-R interval during acquisition varied between 776
and 789 milliseconds.
