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Insights into Imaging
Published in: Insights into Imaging 1/2017

Open Access 01-02-2017 | Pictorial Review

Contrast opacification on thoracic CT angiography: challenges and solutions

Authors: Abhishek Chaturvedi, Daniel Oppenheimer, Prabhakar Rajiah, Katherine A. Kaproth-Joslin, Apeksha Chaturvedi

Published in: Insights into Imaging | Issue 1/2017

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Abstract

Contrast flow and enhancement patterns seen on thoracic CT angiography (CTA) can often be challenging and may often reveal more than is immediately apparent. A non-diagnostic CTA following the initial contrast injection can be secondary to many causes; these include both extrinsic factors, such as injection technique/equipment failure (iv cannula, power injector), and intrinsic, patient-related factors. Contrast pressure and flow graphs often contain useful information regarding the etiology of a non-diagnostic scan. Understanding these graphs will help the radiologist plan a repeat contrast injection to overcome the deficiencies of the first injection and thus obtain a diagnostic scan. The current review article outlines normal and abnormal intravenous contrast dynamics, discusses how to recognize etiologies of non-diagnostic scans, and ultimately addresses techniques to overcome obstacles towards obtaining normal contrast opacification of the target vessel. In addition, there are some life-threatening findings, which unless sought for, may remain hidden in plain sight.
Key Points
• Using contrast enhancement and flow patterns to identify the cause of a non-diagnostic CTA.
• Recognize life threatening causes of altered contrast dynamics such as cardiac asystole.
• Non-target vessel opacification may hold key to underlying pathophysiology.
Appendix
Available only for authorised users
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Metadata
Title
Contrast opacification on thoracic CT angiography: challenges and solutions
Authors
Abhishek Chaturvedi
Daniel Oppenheimer
Prabhakar Rajiah
Katherine A. Kaproth-Joslin
Apeksha Chaturvedi
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
Insights into Imaging / Issue 1/2017
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1007/s13244-016-0524-3

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