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European Radiology
Published in: European Radiology 11/2022

Open Access 12-05-2022 | Phlebothrombosis | Computed Tomography

Indirect CT venography of the lower extremities: impact of scan delay and patient factors on contrast enhancement and examination quality

Authors: Thien Trung Tran, Cathrine Helgestad Kristiansen, Owen Thomas, Sumit Roy, Felix Haidl, Haseem Ashraf, Nils Einar Kløw, Knut Stavem, Peter M. Lauritzen

Published in: European Radiology | Issue 11/2022

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Abstract

Objectives

Indirect computed tomography venography (CTV) is often the next imaging modality for deep vein thrombosis (DVT) when sonography is inconclusive. Our aim was to investigate the impact of scan delay and patient factors on contrast enhancement (CE) and examination quality in CTV.

Methods

Patients with clinical suspicion or clinical mimics of DVT in one large hospital were enrolled. Age, sex, body weight, height, heart rate, systolic blood pressure and cardiac output were registered. CTV of the popliteal veins was obtained at 30 s intervals at 30–210 s delays. The proportions of examinations with CE exceeding predefined cut-offs were estimated and subjective examination quality was rated. Changes in CE with time, and associations between patient factors and time to peak contrast enhancement (TPCE) were modelled with mixed effects non-linear and linear regression, respectively.

Results

The CE increased with increasing scan delay and reached a plateau from 120 to 210 s. The percentages of examinations achieving enhancement above cut-offs across all thresholds from 70 to 100 HU were higher at 120 s compared to 90 s (p < 0.001). After 120 s, there were no differences across scan delays for any thresholds. No patient factors showed a significant effect on TPCE. The percentage of examinations rated as acceptable was higher at 120 s compared to 90 s (p < 0.001). After 120 s, there were no statistically significant differences across scan delays.

Conclusions

No patient factors were associated with TPCE in CTV. A fixed scan delay of 120–210 s yielded the best examination quality.

Key Points

• Contrast enhancement reached a plateau at scan delay between 90 and 120 s.
• A scan delay of 120–210 s yielded the best examination quality.
• No patient factors were associated with time to peak contrast enhancement.
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Metadata
Title
Indirect CT venography of the lower extremities: impact of scan delay and patient factors on contrast enhancement and examination quality
Authors
Thien Trung Tran
Cathrine Helgestad Kristiansen
Owen Thomas
Sumit Roy
Felix Haidl
Haseem Ashraf
Nils Einar Kløw
Knut Stavem
Peter M. Lauritzen
Publication date
12-05-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08841-0

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