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Contrast Enhancement of the Right Ventricle during Coronary CT Angiography--Is It Necessary?

Madeleine Kok1, Bas L J H Kietselaer2, Casper Mihl1

  • 1Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands; CARIM Cardio Vascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.

Plos One
|June 2, 2015
PubMed

Insights

Enhanced right ventricle visualization during coronary CT angiography did not increase pathology detection. This study suggests omitting dedicated right ventricle enhancement in screening coronary CT angiography may be possible, simplifying procedures.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Cardiac CT

Background:

  • Coronary CT angiography (CCTA) is crucial for diagnosing coronary artery disease.
  • Optimizing visualization of cardiac chambers, including the right ventricle (RV), is essential for comprehensive assessment.
  • The necessity of prolonged contrast media injection for improved RV visualization in CCTA remains debated.

Purpose of the Study:

  • To evaluate the impact of dedicated RV enhancement on detecting RV pathology during CCTA.
  • To assess RV enhancement levels and image quality in patients undergoing CCTA.
  • To determine if RV pathology detection is significantly increased with enhanced RV visualization.

Main Methods:

  • Retrospective analysis of 472 patients undergoing screening CCTA.
  • Multidetector-row CT with individualized contrast bolus injection (P3T protocol).
  • Assessment of RV enhancement (HU) and image quality; RV pathology was recorded.

Main Results:

  • Good image quality achieved in 372 patients (mean RV enhancement 268 HU).
  • RV pathology was detected in only three patients (0.63%), all with dilatation.
  • No significant increase in RV pathology detection was observed with dedicated enhancement.

Conclusions:

  • Dedicated RV enhancement during screening CCTA rarely leads to the detection of additional pathology.
  • Observed RV dilatations might be detectable without specific RV enhancement protocols.
  • RV enhancement can potentially be omitted in screening CCTA to streamline the examination.
Abstract

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