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Using thoracic helical CT to assess iodine concentration in a small volume of nonionic contrast medium during
P Loubeyre1, I Debard, C Nemoz
1Service de Radiologie du Centre Hospitalier Lyon Sud, Pierre-Benite, France.
Insights
High iodine concentration nonionic contrast material (350 mg/ml) in low volume (80 ml) effectively enhances mediastinal and hilar vessels during thoracic helical CT. This approach ensures diagnostic vascular enhancement for thoracic evaluations.
Area of Science:
- Radiology
- Medical Imaging
- Diagnostic Imaging
Background:
- Thoracic helical CT is crucial for diagnosing malignancies and infections.
- Optimizing contrast material usage is essential for diagnostic quality and patient safety.
Purpose of the Study:
- To evaluate if diagnostic mediastinal and hilar vascular enhancement can be achieved with a low volume (80 ml) of nonionic contrast material at a slow injection rate (2 ml/sec) during thoracic helical CT.
- To determine the optimal iodine concentration for achieving good vascular enhancement.
Main Methods:
- 120 patients were prospectively enrolled and assigned to receive nonionic contrast material with iodine concentrations of 250, 300, or 350 mg/ml.
- Two radiologists independently graded perivenous artifacts and arterial enhancement on a 4-point scale.
- Quantitative assessment of arterial attenuation values was performed on the aorta and pulmonary artery.
Main Results:
- The highest iodine concentration (350 mg/ml) resulted in mean enhancement scores of 3 or greater for all vessels.
- Higher iodine concentration correlated with higher mean scores, with statistically significant differences between 350 mg/ml and lower concentrations.
- A significant relationship was observed between enhancement scores and arterial attenuation values.
Conclusions:
- Low-volume, high-iodine concentration nonionic contrast medium provides good opacification of central vascular structures in contrast-enhanced helical CT for thoracic evaluations.
- This method allows for diagnostic vascular enhancement with reduced contrast material volume.
Objective:
The goal of the study was to assess whether, using thoracic helical CT, diagnostic mediastinal and hilar vascular enhancement can be obtained with a small amount of nonionic contrast material (80 ml) injected at a relatively slow rate (2 ml/sec).
Subjects And Methods:
One hundred twenty patients (60 in their fourth decade of life and 60 in their seventh decade of life) referred for contrast-enhanced thoracic CT for malignancies or infections prospectively entered the study. They were randomly assigned to be given one of three iodine concentrations of a nonionic contrast material: 250 mg/ml (1250), 300 mg/ml (1300), and 350 mg/ml (1350). Two radiologists independently graded perivenous artifacts and arterial enhancement of mediastinal and hilar vessels on a 4-point scale: 1, poor; 2, fair; 3, good; and 4, excellent. Measurements of arterial attenuation values (quantitative assessment) were obtained on the aorta and pulmonary artery.
Results:
Mean scores were equal to or greater than 3 for all vessels only using 1350. The higher the iodine concentration was, the higher the mean score, but there was a statistically significant difference only between scores obtained with 1350 and those obtained with 1300 or 1250. Mean scores were higher for the patients in their seventh decade of life than those in their fourth decade; however, there was no statistically significant difference between scores of the two decade groups. We found a highly significant statistical relationship between scores and arterial attenuation values.
Conclusion:
During contrast-enhanced helical CT examinations for general thoracic evaluations, good opacification of central vascular structures is obtained with a low volume of high iodine concentration nonionic contrast medium.