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(Radiology. 2000;214:363-371.)
© RSNA, 2000

Vascular and Interventional Radiology

Improved Uniformity of Aortic Enhancement with Customized Contrast Medium Injection Protocols at CT Angiography1

Dominik Fleischmann, MD, Geoffrey D. Rubin, MD, Alexander A. Bankier, MD and Karl Hittmair, MD, MSEE

1 From the Department of Radiology (D.F., A.A.B., K.H.) and the Division of Angiography and Interventional Radiology (K.H.), University of Vienna, AKH, Währinger Gürtel 18-20, A-1090, Austria, and the Department of Radiology, Stanford University Medical Center, Stanford, Calif (D.F., G.D.R.). Received February 5, 1999; revision requested April 2; revision received May 3, 1999; accepted August 1. D. F. supported by a "Schrödinger Stipendium" grant by the Austrian Science Fund, Vienna, Austria. Manuscript preparation was supported in part by the Ludwig Boltzmann Institute for Radiological Sciences, Vienna, Austria. Address reprint requests to D.F. (e-mail: dominik.fleischmann@univie.ac.at).

PURPOSE: To compare the uniformity of aortoiliac opacification obtained from uniphasic contrast medium injections versus individualized biphasic injections at computed tomographic (CT) angiography.

MATERIALS AND METHODS: Thirty-two patients with an abdominal aortic aneurysm underwent CT angiography. In 16 patients (group 1), 120 mL of contrast material was administered at a flow rate of 4 mL/sec. In the other 16 patients (group 2), biphasic injection protocols were computed by using mathematic deconvolution of each patient's time-attenuation response to a standardized test injection. Attenuation uniformity was quantified as the "plateau deviation" of enhancement values, which were calculated as the SD of the time-contiguous attenuation values observed during the 30-second scanning period.

RESULTS: Group 2 patients received between 77 and 165 mL (mean, 115 mL) of contrast medium. Initial flow rates ranged from 4.1 to 10.0 mL/sec (mean, 6.8 mL/sec) for the first 4–6 seconds; continuing flow rates ranged from 2.0 to 4.8 mL/sec (mean, 3.1 mL/sec) for the remaining 24–26 seconds. The plateau deviation was significantly smaller in group 2 patients (19 HU) versus group 1 patients (38 HU, P <.001).

CONCLUSION: At CT angiography, tailored biphasic injections led to more uniform aortoiliac enhancement, compared with standard uniphasic injections of contrast medium.

Index terms: Aneurysm, aortic, 98.73, 98.12912, 98.12916 • Aorta, CT, 98.73, 98.12912, 98.12916 • Arteries, CT, 98.12912, 98.12916 • Arteries, iliac, 98.12912, 98.12916 • Computed tomography (CT), angiography, 98.73, 98.12912, 98.12916 • Computed tomography (CT), contrast enhancement, 98.12912, 98.12916




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