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Effect of Patient Weight and Scanning Duration on Contrast Enhancement during Pulmonary Multidetector CT Angiography¹

¹ From the Department of Radiology, University of Pittsburgh, School of Medicine, 200 Lothrop St, Pittsburgh, PA 15213 (K.T.B., C.T., C.H., F.Z.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (T.A.G., C.F.H.); Department of Radiology, Abant zzet Baysal University, School of Medicine, Golkoy-Bolu, Turkey (S.G.); and Siemens Medical Systems, Iselin, NJ (M.M.). Received December 27, 2005; revision requested February 22, 2006; revision received March 17; accepted May 2; final version accepted May 5. Address correspondence to K.T.B. (e-mail: baek{at}upmc.edu).

View larger version (91K): [in this window] [in a new window] [Download PPT slide]   Figure 1a: (a–c) Transverse CT images acquired at the level of the main pulmonary artery and (d, e) bolus-tracking time-enhancement curves; a–d are from one patient scanned with 64-section CT, and e is from a different patient scanned with 16-section CT. Reference image a was obtained prior to contrast medium injection. A circular ROI was placed over the main pulmonary artery to monitor contrast enhancement. Monitoring image b was obtained 10 seconds after contrast medium injection (magnitude of contrast enhancement, 282 HU). In d, the threshold value of 150 HU (arrowhead) and the level of contrast enhancement (282 HU) at 10 seconds are displayed for the first monitoring scan. Diagnostic image c contains ROIs placed over the main pulmonary artery and the ascending and descending aorta. The bolus-trigger threshold level is typically exceeded during the acquisition of the first monitoring scan at 10 seconds. In some patients, the trigger is delayed, probably because of slow circulation or cardiac output. In a patient with cardiac failure (e), it took 22 seconds to reach a threshold value of 125 HU.

View larger version (103K): [in this window] [in a new window] [Download PPT slide]   Figure 1b: (a–c) Transverse CT images acquired at the level of the main pulmonary artery and (d, e) bolus-tracking time-enhancement curves; a–d are from one patient scanned with 64-section CT, and e is from a different patient scanned with 16-section CT. Reference image a was obtained prior to contrast medium injection. A circular ROI was placed over the main pulmonary artery to monitor contrast enhancement. Monitoring image b was obtained 10 seconds after contrast medium injection (magnitude of contrast enhancement, 282 HU). In d, the threshold value of 150 HU (arrowhead) and the level of contrast enhancement (282 HU) at 10 seconds are displayed for the first monitoring scan. Diagnostic image c contains ROIs placed over the main pulmonary artery and the ascending and descending aorta. The bolus-trigger threshold level is typically exceeded during the acquisition of the first monitoring scan at 10 seconds. In some patients, the trigger is delayed, probably because of slow circulation or cardiac output. In a patient with cardiac failure (e), it took 22 seconds to reach a threshold value of 125 HU.

View larger version (71K): [in this window] [in a new window] [Download PPT slide]   Figure 1c: (a–c) Transverse CT images acquired at the level of the main pulmonary artery and (d, e) bolus-tracking time-enhancement curves; a–d are from one patient scanned with 64-section CT, and e is from a different patient scanned with 16-section CT. Reference image a was obtained prior to contrast medium injection. A circular ROI was placed over the main pulmonary artery to monitor contrast enhancement. Monitoring image b was obtained 10 seconds after contrast medium injection (magnitude of contrast enhancement, 282 HU). In d, the threshold value of 150 HU (arrowhead) and the level of contrast enhancement (282 HU) at 10 seconds are displayed for the first monitoring scan. Diagnostic image c contains ROIs placed over the main pulmonary artery and the ascending and descending aorta. The bolus-trigger threshold level is typically exceeded during the acquisition of the first monitoring scan at 10 seconds. In some patients, the trigger is delayed, probably because of slow circulation or cardiac output. In a patient with cardiac failure (e), it took 22 seconds to reach a threshold value of 125 HU.

View larger version (12K): [in this window] [in a new window] [Download PPT slide]   Figure 1d: (a–c) Transverse CT images acquired at the level of the main pulmonary artery and (d, e) bolus-tracking time-enhancement curves; a–d are from one patient scanned with 64-section CT, and e is from a different patient scanned with 16-section CT. Reference image a was obtained prior to contrast medium injection. A circular ROI was placed over the main pulmonary artery to monitor contrast enhancement. Monitoring image b was obtained 10 seconds after contrast medium injection (magnitude of contrast enhancement, 282 HU). In d, the threshold value of 150 HU (arrowhead) and the level of contrast enhancement (282 HU) at 10 seconds are displayed for the first monitoring scan. Diagnostic image c contains ROIs placed over the main pulmonary artery and the ascending and descending aorta. The bolus-trigger threshold level is typically exceeded during the acquisition of the first monitoring scan at 10 seconds. In some patients, the trigger is delayed, probably because of slow circulation or cardiac output. In a patient with cardiac failure (e), it took 22 seconds to reach a threshold value of 125 HU.

View larger version (16K): [in this window] [in a new window] [Download PPT slide]   Figure 1e: (a–c) Transverse CT images acquired at the level of the main pulmonary artery and (d, e) bolus-tracking time-enhancement curves; a–d are from one patient scanned with 64-section CT, and e is from a different patient scanned with 16-section CT. Reference image a was obtained prior to contrast medium injection. A circular ROI was placed over the main pulmonary artery to monitor contrast enhancement. Monitoring image b was obtained 10 seconds after contrast medium injection (magnitude of contrast enhancement, 282 HU). In d, the threshold value of 150 HU (arrowhead) and the level of contrast enhancement (282 HU) at 10 seconds are displayed for the first monitoring scan. Diagnostic image c contains ROIs placed over the main pulmonary artery and the ascending and descending aorta. The bolus-trigger threshold level is typically exceeded during the acquisition of the first monitoring scan at 10 seconds. In some patients, the trigger is delayed, probably because of slow circulation or cardiac output. In a patient with cardiac failure (e), it took 22 seconds to reach a threshold value of 125 HU.

View larger version (62K): [in this window] [in a new window] [Download PPT slide]   Figure 2a: Transverse CT images are shown for patients with three different body sizes in whom different degrees of contrast enhancement were seen in the main pulmonary arteries. (a) A 64-year-old man weighing 51 kg scanned with 16-section CT (pulmonary enhancement, 472 HU; contrast material volume per body weight index, 2.5 mL per kilogram body weight). (b) A 68-year-old woman weighing 78 kg scanned with 16-section CT (pulmonary enhancement, 328 HU; contrast material volume per body weight index, 1.3 mL/kg). (c) A 62-year-old man weighing 104 kg scanned with 64-section CT (pulmonary enhancement, 182 HU; contrast material volume per body weight index, 1.1 mL/kg).

View larger version (84K): [in this window] [in a new window] [Download PPT slide]   Figure 2b: Transverse CT images are shown for patients with three different body sizes in whom different degrees of contrast enhancement were seen in the main pulmonary arteries. (a) A 64-year-old man weighing 51 kg scanned with 16-section CT (pulmonary enhancement, 472 HU; contrast material volume per body weight index, 2.5 mL per kilogram body weight). (b) A 68-year-old woman weighing 78 kg scanned with 16-section CT (pulmonary enhancement, 328 HU; contrast material volume per body weight index, 1.3 mL/kg). (c) A 62-year-old man weighing 104 kg scanned with 64-section CT (pulmonary enhancement, 182 HU; contrast material volume per body weight index, 1.1 mL/kg).

View larger version (82K): [in this window] [in a new window] [Download PPT slide]   Figure 2c: Transverse CT images are shown for patients with three different body sizes in whom different degrees of contrast enhancement were seen in the main pulmonary arteries. (a) A 64-year-old man weighing 51 kg scanned with 16-section CT (pulmonary enhancement, 472 HU; contrast material volume per body weight index, 2.5 mL per kilogram body weight). (b) A 68-year-old woman weighing 78 kg scanned with 16-section CT (pulmonary enhancement, 328 HU; contrast material volume per body weight index, 1.3 mL/kg). (c) A 62-year-old man weighing 104 kg scanned with 64-section CT (pulmonary enhancement, 182 HU; contrast material volume per body weight index, 1.1 mL/kg).

View larger version (22K): [in this window] [in a new window] [Download PPT slide]   Figure 3: Plot of contrast enhancement in the pulmonary artery against injected contrast material volume per body weight index (CVBWI). For the regression, the intercept was constrained to zero: y = 206x  for 16-section CT () and y = 221x  for 64-section CT () (P < .001). Ninety-five percent CIs were fitted to the regression lines. There was a strong trend for contrast enhancement to increase proportionally with the contrast material volume per body weight index.