Document Detail


Right heart: split-bolus injection of diluted contrast medium for visualization at coronary CT angiography.
MedLine Citation:
PMID:  18372454     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To retrospectively compare a split-bolus contrast medium injection protocol with a biphasic and a monophasic protocol in terms of visualization of the right and left heart, contrast medium-related streak artifacts, and level of attenuation in the cardiac chambers and coronary arteries at coronary computed tomographic (CT) angiography. MATERIALS AND METHODS: The human research committee approved this HIPAA-compliant study and waived informed consent. Seventy-five patients had undergone 64-section coronary CT angiography: 25 were injected by using a monophasic, contrast-medium-only protocol with a single-syringe injector; 25 were injected by using a biphasic protocol with a dual-syringe injector; and 25 were injected by using a split-bolus protocol with a dual-syringe injector and an initial bolus of contrast medium followed by 50 mL of a 70%:30% saline-to-contrast medium mixture and a 30-mL saline chaser. Two radiologists rated the visualization of right and left heart structures and the degree of streak artifacts. One observer performed attenuation measurements of the cardiac chambers and of the coronary arteries. Data were analyzed with one-way analysis of variance and Duncan post-hoc multiple comparison procedures. RESULTS: Data for 27 women and 48 men (mean age, 62 years) were included. Mean contrast medium attenuation in the right heart was significantly (P < .001) higher in the split-bolus group than in the biphasic injection group but was significantly (P < .001) lower than in the monophasic injection group. For the left heart and the coronary arteries, there were no significant differences among the three groups. Artifacts occurred less frequently (P < .001) in the biphasic and split-bolus groups than in the monophasic group. Visualization of right heart structures was rated significantly (P < .05) better in the split-bolus group than in the two other groups, while there was no difference for visualization of left heart structures. CONCLUSION: Split-bolus injection provides sufficient attenuation for visualization of the right heart, while streak artifacts from high-attenuation contrast material can generally be avoided and arterial attenuation is maintained.
Authors:
J Matthias Kerl; James G Ravenel; Shaun A Nguyen; Pal Suranyi; Christian Thilo; Philip Costello; Werner Bautz; U Joseph Schoepf
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-03-27
Journal Detail:
Title:  Radiology     Volume:  247     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-23     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  356-64     Citation Subset:  AIM; IM    
Copyright Information:
(c) RSNA, 2008.
Affiliation:
Department of Radiology, Medical University of South Carolina, 169 Ashley Ave, Charleston, SC 29425, USA.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Artifacts
Contrast Media / administration & dosage*
Coronary Angiography / methods*
Female
Humans
Injections, Intravenous
Iopamidol / administration & dosage*
Male
Middle Aged
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Contrast Media; 62883-00-5/Iopamidol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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