Spectral computed tomography angiography using a gadolinium-based contrast agent for imaging of pathologies of the...

Area of Science:

• Radiology
• Medical Imaging
• Cardiovascular Imaging

Background:

• Patients with aortic aneurysms often require multiple CTAs.
• Iodine-based contrast agents may be contraindicated due to medical conditions.
• Gadolinium-based contrast agents (Gd-CTA) present a potential alternative.

Purpose of the Study:

• To evaluate the feasibility of spectral computed tomography angiography (CTA) using a gadolinium-based contrast agent.
• To assess its utility in patients with aortic aneurysms who have contraindications for iodine-based contrast agents.

Main Methods:

• Spectral CT was performed on 15 patients (21 scans) with aortic aneurysms.
• Patients had contraindications for iodine-based contrast agents.
• Gd-based contrast agent was administered at routine doses (0.2 mmol/kg).
• Monoenergetic reconstructions were computed from spectral data.

Main Results:

• Significant increase in intravascular aortic attenuation with Gd-CTA (p < 0.001).
• Monoenergetic reconstructions (MonoE40) showed significantly higher contrast ratios compared to conventional imaging.
• Thoracic aorta: 6.5±4.5 (MonoE40) vs. 2.4±0.5 (conventional), p=0.003.
• Abdominal aorta: 4.1±1.8 (MonoE40) vs. 1.9±0.5 (conventional), p < 0.001.

Conclusions:

• Gd-CTA is a valid and reliable alternative for diagnostic aortic imaging.
• Monoenergetic reconstructions using Gd-CTA are useful for patients with aortic aneurysms and iodine contraindications.