High-pitch carbon dioxide contrasted CT angiography: pilot study

Area of Science:

• Medical Imaging
• Vascular Imaging
• Computed Tomography

Background:

• Iodinated contrast agents (ICAs) pose risks for patients with contraindications.
• Alternative contrast agents are needed for vascular imaging in specific patient populations.

Purpose of the Study:

• To evaluate the feasibility and image quality of carbon dioxide computed tomography angiography (CO2-CTA) for iliac and lower limb arteries.
• To compare CO2-CTA with carbon dioxide-fluoroscopic enhanced angiography (CO2-FLA) in patients with contraindications for ICA.

Main Methods:

• Five patients with contraindications for ICA underwent CO2-FLA and CO2-CTA using a high-pitch protocol.
• Objective (vessel diameter) and subjective (visual score) image quality parameters were assessed.
• Pathological findings between the two modalities were compared.

Main Results:

• CO2-CTA was feasible in all patients, with pain at injection as the only side effect.
• No significant difference in vessel diameters was found between CO2-CTA and CO2-FLA.
• CO2-CTA achieved higher average image quality scores, particularly for pelvic and upper leg vessels.

Conclusions:

• CO2-CTA with high-pitch CT is a feasible imaging technique for selected patients.
• While overall image quality is improved compared to CO2-FLA, visualization of calf vessels requires further protocol refinement.
• Cross-sectional imaging with CO2-CTA shows potential added value that warrants further investigation.