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. 2016 Mar-Apr;49(2):75-8.
doi: 10.1590/0100-3984.2014.0115.

Pulmonary 64-MDCT angiography with 50 mL of iodinated contrast material in an unselected patient population: a feasible protocol

Henrique Simão Trad  1 , Gustavo Santos Boasquevisque  1 , Tiago Rangon Giacometti  2 , Catherine Yang Trad  1 , Orlando Salomão Zoghbi Neto  1 , Clovis Simão Trad  1
Affiliations

Pulmonary 64-MDCT angiography with 50 mL of iodinated contrast material in an unselected patient population: a feasible protocol

Henrique Simão Trad et al. Radiol Bras. 2016 Mar-Apr.

Abstract
in English, Portuguese

Objective: To propose a protocol for pulmonary angiography using 64-slice multidetector computed tomography (64-MDCT) with 50 mL of iodinated contrast material, in an unselected patient population, as well as to evaluate vascular enhancement and image quality.

Materials and methods: We evaluated 29 patients (22-86 years of age). The body mass index ranged from 19.0 kg/m(2) to 41.8 kg/m(2). Patients underwent pulmonary CT angiography in a 64-MDCT scanner, receiving 50 mL of iodinated contrast material via venous access at a rate of 4.5 mL/s. Bolus tracking was applied in the superior vena cava. Two experienced radiologists assessed image quality and vascular enhancement.

Results: The mean density was 382 Hounsfield units (HU) for the pulmonary trunk; 379 and 377 HU for the right and left main pulmonary arteries, respectively; and 346 and 364 HU for the right and left inferior pulmonary arteries, respectively. In all patients, subsegmental arteries were analyzed. There were streak artifacts from contrast material in the superior vena cava in all patients. However, those artifacts did not impair the image analysis.

Conclusion: Our findings suggest that pulmonary angiography using 64-MDCT with 50 mL of iodinated contrast can produce high quality images in unselected patient populations.

Objetivo: Propusemos um protocolo com 50 mL de contraste, sem seleção de população e testamos o contraste vascular e a qualidade de imagem.

Materiais e métodos: Vinte e nove pacientes com idades entre 22 e 86 anos, com índice de massa corporal de 19,0 a 41,8 kg/m2, realizaram angiografia pulmonar em equipamento de 64 detectores. Foram injetados 50 mL de contraste iodado em acesso venoso periférico, na taxa de 4,5 mL/s2, com técnica de bolus tracking na veia cava superior. Dois radiologistas experientes avaliaram o realce vascular e a qualidade de imagem.

Resultados: A densidade média no tronco pulmonar, ramos direito e esquerdo, artérias pulmonares inferiores direita e esquerda foram, respectivamente, 382, 379, 377, 346 e 364 unidades Hounsfield. Artérias subsegmentares foram avaliadas em todos os casos. Artefatos por restos de contraste na veia cava superior estavam presentes em todos os casos, sem prejudicar a avaliação das imagens.

Conclusão: Angiotomografia pulmonar pode ser realizada com 50 mL de contraste iodado, sem necessidade de seleção dos pacientes e apesar de suas características físicas, com boa qualidade de imagem.

Keywords: Angiography; Contrast media; Pulmonary embolism; Tomography, X-ray computed.

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Figures

Figure 1
Figure 1
Bolus tracking control image with a fully filled superior vena cava.
Figure 2
Figure 2
Assessment of vascular enhancement in the pulmonary trunk; right and left main pulmonary arteries; and right and left inferior pulmonary arteries.
See this image and copyright information in PMC

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