Low-Volume Contrast Medium Protocol for Comprehensive Cardiac and Aortoiliac CT Assessment in the Context of Transcatheter Aortic Valve Replacement
| Autor: | U. Joseph Schoepf, Lucas L. Geyer, Justin R. Silverman, Aleksander W. Krazinski, Daniel H. Steinberg, Fabian Bamberg, Carlo N. De Cecco |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Transcatheter aortic Computed Tomography Angiography Image quality medicine.medical_treatment Cardiac-Gated Imaging Techniques Contrast Media Context (language use) Signal-To-Noise Ratio Radiation Dosage Aortography Iliac Artery Patient Care Planning Transcatheter Aortic Valve Replacement Valve replacement Triiodobenzoic Acids Image Processing Computer-Assisted medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Heart Aortic Valve Stenosis Low volume Contrast medium Angiography Feasibility Studies Female Radiology Bolus (digestion) Tomography X-Ray Computed business |
| Zdroj: | Academic Radiology. 22:1138-1146 |
| ISSN: | 1076-6332 |
| DOI: | 10.1016/j.acra.2015.03.018 |
| Popis: | Rationale and Objectives To investigate the diagnostic performance of a comprehensive computed tomography (CT) protocol for both cardiac and aortoiliac evaluation of patients considered for transcatheter aortic valve replacement (TAVR) using a single, low-volume contrast medium (CM) injection. Materials and Methods Forty-four TAVR candidates were retrospectively analyzed. All underwent retrospectively electrocardiogram-gated cardiac CT followed by high-pitch CT angiography of the aortoiliac vasculature using one of two single injection protocols of 320 mgI/mL iodine CM: group A ( n = 22), iodine delivery rate-based (1.28 gI/s), 60-mL CM volume, 4.0 mL/s flow rate; group B ( n = 22), clinical routine protocol, 100-mL CM volume, 4.0 mL/s flow rate. Mean arterial attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated. Subjective image quality was assessed. Results Aortic root and iliofemoral dimensions could be analyzed in all cases. Patient characteristics showed no significant differences. Mean attenuation at the levels of the aortic root (285.8 ± 83.0 HU vs 327.5 ± 70.8 HU, P = .080) and the iliofemoral access route (256.8 ± 88.5 HU vs 307.5 ± 93.2 HU, P = .071), as well as SNR and CNR were nonsignificantly lower in group A compared to group B. Subjective image quality was equivalent. Conclusions In multimorbid TAVR patients, the performance of a combined CT protocol using a single low-volume CM bolus is feasible with maintained image quality compared to a standard protocol. |
| Databáze: | OpenAIRE |
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