Comparison of different iodine concentrations for multidetector row computed tomography angiography of segmental renal arteries

Abstract

The aims of this study were (1) to assess the diagnostic performance of multidetector row computed tomography angiography (CTA) on imaging of renal artery branches and (2) to investigate the effect of different iodine concentrations at constant total iodine load and either constant injection rates or constant iodine administration rates. A number of 120 consecutive patients (71+/-6 years of age) underwent CTA of renal arteries (collimation 4 x 1 mm) using the nonionic contrast medium iopromide, and were divided into six equal groups: 1: 150 ml, 240 mg/ml at 4 ml/s; 2: 120 ml, 300 mg/ml at 4 ml/s; 3: 97.3 ml, 370 mg/ml at 4 ml/s; 4: 150 ml, 240 mg/ml at 5 ml/s; 5: 120 ml, 300 mg/ml, 60 ml at 6 ml/s, 60 ml at 3 ml/s; 6: 97.3 ml, 370 mg/ml at 3.3 ml/s. The image quality of the main renal arteries (n=240) and their first-order to fourth-order branches was scored as 0 for no visualization, 1 for only visualization, and 2 for diagnostic. All main renal arteries were diagnostic. First-order branches had score 2 in 38/40, 40/40, 37/40, 38/40, 39/40, and 40/40 patients for groups 1-6, respectively (p=0.34). Second-order branches were imaged best in group 2 (p<0.002)). Third-order branches had score 2 in only 1/40, 5/40, 1/40, 2/40, 0/40, and 2/40 renal arteries. Fourth-order branches were not imaged diagnostically. At a constant total iodine load, the main renal arteries and their first-order branches achieved diagnostic image quality at all iodine concentrations in four-channel multidetector row CTA for the protocols tested. Second-order renal artery branches were imaged best at 120 ml contrast medium with an iodine concentration of 300 mg/ml at 4 ml/s.