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European Radiology
Published in: European Radiology 8/2016

Open Access 01-08-2016 | Vascular-Interventional

Low contrast media volume in pre-TAVI CT examinations

Authors: Madeleine Kok, Jakub Turek, Casper Mihl, Sebastian D. Reinartz, Robin F. Gohmann, Estelle C. Nijssen, Suzanne Kats, Vincent G. van Ommen, Bas L. J. H. Kietselaer, Joachim E. Wildberger, Marco Das

Published in: European Radiology | Issue 8/2016

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Abstract

Purpose

To evaluate image quality using reduced contrast media (CM) volume in pre-TAVI assessment.

Methods

Forty-seven consecutive patients referred for pre-TAVI examination were evaluated. Patients were divided into two groups: group 1 BMI < 28 kg/m2 (n = 29); and group 2 BMI > 28 kg/m2 (n = 18). Patients received a combined scan protocol: retrospective ECG-gated helical CTA of the aortic root (80kVp) followed by a high-pitch spiral CTA (group 1: 70 kV; group 2: 80 kVp) from aortic arch to femoral arteries. All patients received one bolus of CM (300 mgI/ml): group 1: volume = 40 ml; flow rate = 3 ml/s, group 2: volume = 53 ml; flow rate = 4 ml/s. Attenuation values (HU) and contrast-to-noise ratio (CNR) were measured at the levels of the aortic root (helical) and peripheral arteries (high-pitch). Diagnostic image quality was considered sufficient at attenuation values > 250HU and CNR > 10.

Results

Diagnostic image quality for TAVI measurements was obtained in 46 patients. Mean attenuation values and CNR (HU ± SD) at the aortic root (helical) were: group 1: 381 ± 65HU and 13 ± 8; group 2: 442 ± 68HU and 10 ± 5. At the peripheral arteries (high-pitch), mean values were: group 1: 430 ± 117HU and 11 ± 6; group 2: 389 ± 102HU and 13 ± 6.

Conclusion

CM volume can be substantially reduced using low kVp protocols, while maintaining sufficient image quality for the evaluation of aortic root and peripheral access sites.

Key points

• Image quality could be maintained using low kVp scan protocols.
• Low kVp protocols reduce contrast media volume by 34–67 %.
• Less contrast media volume lowers the risk of contrast-induced nephropathy.
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Metadata
Title
Low contrast media volume in pre-TAVI CT examinations
Authors
Madeleine Kok
Jakub Turek
Casper Mihl
Sebastian D. Reinartz
Robin F. Gohmann
Estelle C. Nijssen
Suzanne Kats
Vincent G. van Ommen
Bas L. J. H. Kietselaer
Joachim E. Wildberger
Marco Das
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4080-x

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