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Dimeric versus monomeric nonionic contrast agents in visualization of coronary arteries
R Rienmüller1, O Brekke, V B Kampenes
1Landeskrankenhaus - Universitätsklinikum Graz, Division of General Radiology, Auenbruggerplatz 9/P, A-8036, Graz, Austria. rienmuel@kfunigraz.ac.at
European Journal of Radiology
|June 12, 2001
Summary
Iodixanol, a dimeric contrast agent, effectively visualizes coronary arteries using electron beam tomography (EBT) despite lower iodine concentration. This study confirms non-inferior diagnostic quality compared to iohexol, enabling reduced iodine administration.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Contrast Agents
Background:
- Electron beam tomography (EBT) uses intravenous iodine contrast agents for coronary artery visualization.
- Visualization quality is often limited by similar CT values in coronary arteries and myocardial tissue.
- Dimeric contrast agents like iodixanol offer potential advantages in contrast kinetics and iodine concentration.
Purpose of the Study:
- To evaluate the effect of iodixanol's lower iodine concentration and dimeric properties on contrast kinetics and coronary artery visualization in EBT under clinical conditions.
- To compare iodixanol with iohexol, a non-dimeric agent, in terms of diagnostic image quality and coronary artery assessment.
- To determine if reduced iodine concentration with iodixanol impacts diagnostic information obtained via EBT.
Main Methods:
- A double-blind, randomized, parallel study involving 111 cardiac patients.
- Comparison of iodixanol (270 mg I/ml) versus iohexol (300 mg I/ml) for contrast enhancement.
- Kinetic analysis included contrast arrival and peak times in pulmonary trunk and aorta, CT values in the left ventricle and myocardium, and body mass index correlation.
- Assessment of visualized coronary artery length and diagnostic quality using a visual analogue scale.
Main Results:
- No significant statistical difference was observed between iodixanol and iohexol groups in diagnostic visualization or length assessment of coronary arteries.
- The mean difference in CT values between the left ventricular chamber and myocardium was comparable between both contrast agents.
- Despite a lower iodine concentration, iodixanol demonstrated comparable performance to iohexol in kinetic parameters and image quality.
Conclusions:
- Iodixanol's dimeric characteristics allow for effective coronary artery visualization using EBT even with a lower iodine concentration.
- Reduced iodine administration is feasible without compromising diagnostic image quality or information in EBT coronary angiography.
- Dimeric contrast agents like iodixanol represent a valuable option for optimizing contrast agent use in cardiovascular imaging.