Contrast-enhanced angiographic cone-beam computed tomography without pre-diluted contrast medium

Area of Science:

• Medical Imaging
• Radiology
• Vascular Interventions

Background:

• Contrast-enhanced cone-beam computed tomography (CBCT) is valuable for assessing vascular anatomy and neurovascular stents.
• Current CBCT protocols necessitate quantitative contrast dilution for optimal image quality.
• This study introduces methods to achieve contrast-enhanced CBCT without quantitative dilution.

Purpose of the Study:

• To develop and evaluate simple methods for obtaining contrast-enhanced CBCT without quantitative contrast dilution.
• To assess the feasibility and efficacy of these new methods in evaluating neurovascular stents and host arteries.

Main Methods:

• Internal carotid artery flow rate changes were estimated using transcranial Doppler (TCD) before and after catheterization and fluid infusion.
• Contrast infusions (0.3 cm³/s and 0.2 cm³/s) followed by saline flushes (300 mmHg pressure bag) were administered.
• The technique was applied to evaluate neurovascular stents and host arteries in patients.

Main Results:

• Flow velocities showed significant changes during catheterization (-15 ± 6.8%) and guiding catheter flushing (+17 ± 5.5%).
• Successful evaluation of stents and vascular structures was achieved in all patients.
• The 0.2 cm³/s contrast infusion protocol demonstrated superior quality for evaluating stents and host arteries.

Conclusions:

• Contrast-enhanced CBCT is feasible without quantitative contrast dilution.
• Adequate contrast enhancement can be achieved using a small saline flush and normal blood flow.
• This simplified approach enhances the utility of CBCT in vascular imaging.