Download Feasibility of contrast agent volume reduction on 640

Feasibility of contrast agent volume reduction on 640-slice
CT coronary angiography in patients with low heart rate
Poster No.:
B-0742
Congress:
ECR 2013
Type:
Scientific Paper
Authors:
Z. Ding, Z. Wang; Hangzhou/CN
Keywords:
Cardiac, Cardiovascular system, Contrast agents, CTAngiography, Contrast agent-intravenous, Cost-effectiveness,
Technology assessment, Hemodynamics / Flow dynamics
DOI:
10.1594/ecr2013/B-0742
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Purpose
640-slice dynamic volume CT (DVCT) allows for whole-heart acquisition within 0.35s
in a single heart beat, which provides the possibility to reduce the amount of contrast
agent because the scan time is reduced. This study aimed to optimize the contrast
injection protocol for coronary CT angiography (CTA) to achieve more efficient utilization
of contrast agent by investigating the impact of reducing the volume of contrast agent on
the attenuation of coronary arteries and coronary sinus.
Methods and Materials
A total of 105 subjects with low heart rate (# 65 beats/min) and suspected coronary artery
disease were randomly divided into three groups with 35 subjects in each group. The
patients in Groups A, B and C were injected with a volume of 0.8, 0.7, and 0.6 ml/kg
of contrast agent, respectively. In all cases, injection rate was 5.0ml/s, followed by 30ml
saline flush at the same rate. CT values within the ascending and descending aorta,
left main and right coronary artery orifices and coronary sinus were measured and the
differences of contrast enhancement among the three groups were evaluated.
Images for this section:
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Fig. 2: Curved planar reconstruction (CPR) of the coronary sinus shows that the degree
of contrast enhancement within the coronary sinus is affected by the reflux of contrast
material into the right atrium (long arrow) and the reflux of the contrast material into the
coronary veins (short arrow).
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Fig. 3: Tracking the contrast material shows that the contrast moves from right atrium to
right ventricle, to left atrium (not shown), to left ventricle, and then to the coronary artery.
Reflux of contrast material from right artium into the coronary sinus can be observed in
different phases of enhancement.
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Fig. 4: Volumetric imaging shows that imaging of the coronary vein is accompanied by
(or intersected by) braches of the left coronary artery (LAD and LCX), which interfere with
the image quality of the coronary arteries.
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Results
The mean injection volume of contrast agent in Groups A, B and C was 54.1, 47.9
and 41.1 ml respectively (P < 0.001), and the scan delay time was 23.7, 23.4 and 22.2
s, respectively (P < 0.05). The CT values within the coronary sinus were 112.7, 93.7
and 81.2 HU for Groups A, B, and C respectively (P < 0.001), and CT values within
the ascending and descending aorta, and the coronary artery were higher than 300
Hounsfield units in all 3 groups.
Images for this section:
Fig. 1: The results of the analysis with respect to attenuation in the evaluated coronary
artery segments, aorta and coronary sinus are illustrated.
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Conclusion
Application of the 0.6 ml/kg protocol in coronary CTA, a steady contrast enhancement in
coronary artery, can be achieved using 640-slice volume CT. The utilization of contrast
agent can be optimized with shorten the duration of contrast agent injection.
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