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The International Journal of Cardiovascular Imaging

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Open Access 01-10-2020 | Original Paper

Dual-energy CT angiography in suspected pulmonary embolism: influence of injection protocols on image quality and perfused blood volume

Authors: Aleksander Kosmala, Philipp Gruschwitz, Simon Veldhoen, Andreas Max Weng, Bernhard Krauss, Thorsten Alexander Bley, Bernhard Petritsch

Published in: The International Journal of Cardiovascular Imaging | Issue 10/2020

Abstract

To compare intravenous contrast material (CM) injection protocols for dual-energy CT pulmonary angiography (CTPA) in patients with suspected acute pulmonary embolism with regard to image quality and pulmonary perfused blood volume (PBV) values. A total of 198 studies performed with four CM injection protocols varying in CM volume and iodine delivery rates (IDR) were retrospectively included: (A) 60 ml at 5 ml/s (IDR = 1.75gI/s), (B) 50 ml at 5 ml/s (IDR = 1.75gI/s), (C) 50 ml at 4 ml/s (IDR = 1.40gI/s), (D) 40 ml at 3 ml/s (IDR = 1.05gI/s). Image quality and PBV values at different resolution settings were compared. Pulmonary arterial tract attenuation was highest for protocol A (397 ± 110 HU; p vs. B = 0.13; vs. C = 0.02; vs. D < 0.001). CTPA image quality of protocol A was rated superior compared to protocols B and D by reader 1 (p = 0.01; < 0.001), and superior to protocols B, C and D by reader 2 (p < 0.001; 0.02; < 0.001). Otherwise, there were no significant differences in CTPA quality ratings. Subjective iodine map ratings did not vary significantly between protocols A, B, and C. Both readers rated protocol D inferior to all other protocols (p < 0.05). PBV values did not vary significantly between protocols A and B at resolution settings of 1, 4 and 10 (p = 0.10; 0.10; 0.09), while otherwise PBV values displayed a decreasing trend from protocol A to D (p < 0.05). Higher CM volume and IDR are associated with superior CTPA and iodine map quality and higher absolute PBV values.

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Title: Dual-energy CT angiography in suspected pulmonary embolism: influence of injection protocols on image quality and perfused blood volume
Authors: Aleksander Kosmala
Philipp Gruschwitz
Simon Veldhoen
Andreas Max Weng
Bernhard Krauss
Thorsten Alexander Bley
Bernhard Petritsch
Publication date: 01-10-2020
Publisher: Springer Netherlands
Published in: The International Journal of Cardiovascular Imaging / Issue 10/2020
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-020-01911-8

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