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Updated: May 14, 2026
Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
Published on: December 9, 2021
Bolus timing in high-pitch CT angiography of the aorta
Martin Beeres1, Matthias Loch, Boris Schulz
1Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. beeres@gmx.net
Insights
High-pitch CT angiography achieves homogeneous aortic enhancement with a 10-second delay, significantly reducing scan times compared to conventional methods. This optimized technique improves diagnostic quality without ECG synchronization.
Area of Science:
- Radiology
- Medical Imaging
- Cardiovascular Imaging
Background:
- Computed Tomography Angiography (CTA) is crucial for aortic assessment.
- ECG-synchronized CTA can be limited by heart rate variability.
- High-pitch CT offers faster acquisition but requires optimization for contrast enhancement.
Purpose of the Study:
- To evaluate bolus geometry in high-pitch CT angiography (CTA) of the aorta.
- To compare high-pitch CTA without ECG synchronization to single-source CT.
- To determine optimal contrast timing for homogeneous aortic enhancement in high-pitch CTA.
Main Methods:
- 160 patients underwent CTA in single-source (pitch 1.2) or dual-source high-pitch (pitch 3.0) modes.
- Contrast media timings were varied (5s, 10s, 12s, 14s) with bolus triggering at 140 HU.
- Aortic attenuation was measured along the z-axis, and subjective image quality was assessed.
Main Results:
- A 10-second delay after trigger threshold provided the most homogeneous aortic enhancement.
- High-pitch CTA significantly reduced examination time (1.7s vs. 7.7s).
- Imaging length was not significantly different between groups.
Conclusions:
- High-pitch CTA with a 10s delay achieves homogeneous contrast enhancement along the aorta's z-axis.
- This technique provides excellent aortic visualization without ECG synchronization.
- Optimized timing in high-pitch CTA enhances diagnostic efficiency and image quality.
Objective:
To investigate the bolus geometry in high-pitch CT angiography (CTA) of the aorta without ECG synchronisation in comparison to single-source CT.
Methods:
Overall 160 consecutive patients underwent CTA either in conventional single-source mode with a pitch of 1.2 (group 1), or in dual-source mode with a pitch of 3.0 (groups 2, 3 and 4) using different contrast media timings with bolus triggering at 140 HU (5s, group 1; 10s, group 2; 12s, group 3; 14s, group 4). Contrast material, saline flush, flow rate and kV/mAs settings were kept equal for optimum comparability. Aortic attenuation was measured along the z-axis of the patient at different anatomic landmarks and subjective image quality was compared.
Results:
The most homogeneous enhancement of the aorta was reached with a delay of 10s after reaching the trigger threshold. The imaging length was not significantly different, but the examination time was significantly (p<0.001) shorter in the high-pitch group (7.7s vs. 1.7s for group 1 vs. 2, 3 and 4).
Conclusion:
In high-pitch CT angiography using a start delay of 10s after a trigger threshold of 140 HU in the descending aorta is reached, a homogenous contrast along the z-axis is accomplished.
