Simultaneous bilateral contrast injection in computed tomography pulmonary angiography

Area of Science:

• Radiology
• Medical Imaging
• Cardiovascular Imaging

Background:

• Computed tomography pulmonary angiography (CTPA) is the standard for diagnosing pulmonary embolism.
• Subsegmental arteries are often not evaluated due to insufficient contrast attenuation.

Purpose of the Study:

• To compare simultaneous bilateral versus unilateral contrast media injection in CTPA.
• To assess the impact on pulmonary artery opacification and image quality.

Main Methods:

• 180 patients with suspected pulmonary embolism were randomized into four groups.
• Groups received either unilateral or bilateral contrast injection at varying rates (4-8 mL/s).
• Attenuation and image quality of pulmonary arteries, including subsegmental vessels, were evaluated.

Main Results:

• Bilateral injection resulted in significantly higher pulmonary artery attenuation (P < 0.001).
• Subsegmental artery assessment was feasible in all patients with bilateral injection.
• Image quality was diagnostic for all groups, with the best results in the bilateral, higher-rate injection group.

Conclusions:

• Bilateral contrast injection in CTPA enhances pulmonary artery opacification and image quality.
• This technique improves the assessment of subsegmental pulmonary arteries.
• Bilateral injection is a superior method for contrast delivery in CTPA.