Abstract：
OBJECTIVES:To investigate pulmonary vasculature opacification during CTPA using an optimised patient-specific protocol for administering contrast agent. METHODS:CTPA was performed on 200 patients with suspected PE. Patients were assigned to two protocol groups: protocol A, fixed 80 ml contrast agent; protocol B used a patient-specific approach. The mean cross-sectional opacification profile of 8 central and 11 peripheral pulmonary arteries and veins was measured and the arteriovenous contrast ratio (AVCR) calculated. Protocols were compared using Mann-Whitney U non-parametric statistics. Jack-knife alternative free-response receiver-operating characteristic (JAFROC) analyses assessed diagnostic efficacy. Interobserver variations were investigated using kappa methods. RESULTS:A number of pulmonary arteries demonstrated increases in opacification (P < 0.03) for protocol B compared to A, whilst opacification in the heart and veins was reduced in protocol B (P = 0.05). Increased AVCR in protocol B compared with A was observed at all anatomic locations (P < 0.0002). Increased JAFROC (P < 0.0002) and kappa variation were observed with protocol B (κ = 0.78) compared to A (κ = 0.25). Mean contrast volume was reduced in protocol B (33 ± 9 ml) compared to A (80 ± 1 ml). CONCLUSIONS:Significant improvements in visualisation of the pulmonary vasculature can be achieved with a low volume of contrast agent using injection timing based on a patient-specific contrast formula. KEY POINTS:• Optimal opacification of the pulmonary arteries is essential for CT pulmonary angiography. • Matching timing with vessel dynamics significantly improves vessel opacification. • This leads to increased arterial opacification and reduced venous opacification. • This can also lead to a reduced volume of contrast agent.
journal_name
Eur Radioljournal_title
European radiologyauthors
Saade C,Bourne R,El-Merhi F,Somanathan A,Chakraborty D,Brennan Pdoi
10.1007/s00330-013-2919-6subject
Has Abstractpub_date
2013-11-01 00:00:00pages
3205-12issue
11eissn
0938-7994issn
1432-1084journal_volume
23pub_type
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