Cerebral CT angiography using a small volume of concentrated contrast material with a test injection method: optimal scan delay for quantitative and qualitative performance

Takeyama, Nobuyuki; Kuroki, Kazutaka; Hayashi, Tetsuji; S, Sai; Okabe, Naota; Kinebuchi, Yuko; Hashimoto, Takeji; Gokan, Takehiko

doi:10.1259/bjr/31882420

Cited by 11 publications

(3 citation statements)

References 19 publications

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“…Initially the intraarterial injection was to be 30 mL of 350 mgI/mL iohexol. This dose was chosen as it was within the range of reported volumes used in human cranial CT angiography . During the initial scan we discovered that the use of the power injector and 350 mgI/ml contrast medium created significant artifact due to the tight bolus of contrast medium with very little dilution in the blood pool.…”

Section: Discussionmentioning

confidence: 99%

Intraarterial Injection of Iodinated Contrast Medium for Contrast Enhanced Computed Tomography of the Equine Head

Carmalt

Montgomery

2015

Vet Radiology Ultrasound

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Minimizing the volume of contrast administered for contrast-enhanced computed tomography (CT) of the equine head is desirable for reducing costs and risks of adverse reactions, however evidence-based studies on the effects of varying volumes on image quality are currently lacking. The objective of the current study was to determine whether low-volume intraarterial administration of contrast medium would result in an equivalent image quality and tissue attenuation vs. high-volume intravenous bolus administration. A prospective cross-over experimental design was used in a sample of six horses. After anesthetic induction, the right carotid artery was exposed surgically and catheterized. Four CT scans of the cranium were performed for each horse: baseline, immediately following intraarterial contrast injection, five-min postinjection (return to baseline) and a final scan after intravenous contrast administration. Soft tissue attenuation in predetermined regions of interest (ROI); and length, width, and height measurements of the pituitary gland were recorded at each time point. Horses were euthanized and measurements of the pituitary gland were repeated postmortem. No adverse reactions to contrast administration were observed. Intraarterial and intravenous administration of contrast medium resulted in significantly greater soft tissue enhancement of some brain ROI's and the pituitary gland vs. baseline values. Pituitary gland measurements made on postcontrast CT images did not differ from those obtained during postmortem examination. Findings indicated that low-dose intraarterial administration of contrast material in the equine head resulted in comparable soft tissue enhancement vs. high volume intravenous administration.

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Section: Discussionmentioning

confidence: 99%

Intraarterial Injection of Iodinated Contrast Medium for Contrast Enhanced Computed Tomography of the Equine Head

Carmalt

Montgomery

2015

Vet Radiology Ultrasound

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“…Current standard of practice preferentially administers RSI injections due to the empiric understanding that this results in improved vessel opacification due to shorter venous course to the heart, less venous reflux, and perivenous artifact. Although there are many studies elucidating the effects of CT scanning parameters, contrast injection protocols, and reconstruction techniques on CTAs, 10,14,[21][22][23][24][25][26][27] few have directly investigated right-sided versus left-sided upper extremity contrast injection effects on vessel opacification. Furthermore, it is not known if there are patients who might benefit more from RSI.…”

Section: Discussionmentioning

confidence: 99%

Effect of Right-Sided Versus Left-Sided Contrast Injection on Intra-arterial Opacification Characteristics of Head and Neck Computed Tomography Angiograms and Interactions With Patient Sex, Weight, and Cardiac Output

Chang

Tsai²,

Gutierrez³

et al. 2015

Journal of Computer Assisted Tomography

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“…11 As the degree of cardiac output or the presence of vascular obstruction could affect differences in contrast media arrival in various areas of the cerebral vasculature, we could miss the optimal scan timing with sufficient enhancement for entire intracranial arteries or veins, given such a short scan duration. Therefore, it is important to optimize the scan delay 12 to achieve acceptable CTA using bolus tracking. 6,13 However, to the best of our knowledge, the optimal scan timing for artery-vein separation at whole-brain CTA using 320-row MDCT has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

Optimal scan timing for artery–vein separation at whole-brain CT angiography using a 320-row MDCT volume scanner

Shirasaka¹,

Hiwatashi²,

Yamashita³

et al. 2017

The British Journal of Radiology

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Objective: A 320-row multidetector CT (MDCT) is expected for a good artery-vein separation in terms of temporal resolution. However, a shortened scan duration may lead to insufficient vascular enhancement. We assessed the optimal scan timing for the artery-vein separation at whole-brain CT angiography (CTA) when bolus tracking was used at 320-row MDCT. Methods: We analyzed 60 patients, who underwent whole-brain four-dimensional CTA. Difference in CT attenuation between the internal carotid artery (ICA) and the superior sagittal sinus (D att ) was calculated in each phase. Using a visual evaluation score for the depiction of arteries and veins, we calculated the difference between the mean score for the intracranial arteries and the mean score for the veins (D score ). We assessed the time at which the maximum D att and D score were simultaneously observed. Results: The maximum D att was observed at 6.0 s and 8.0 s in the arterial-dominant phase and at 16.0 s and 18.0 s in the venous-dominant phase after the contrast media arrival time at the ICA (T aa ). The maximum D score was observed at 6.0 s and 8.0 s in the arterial-dominant phase and at 16.0 s in the venous-dominant phase after the T aa . There were no statistically significant differences in D att (p 5 0.375) or D score (p 5 0.139) between these scan timings. Conclusion: The optimal scan timing for artery-vein separation at whole-brain CTA was 6.0 s or 8.0 s for the arteries and 16.0 s for the veins after the T aa . Advances in knowledge: Optimal scan timing allowed us to visualize intracranial arteries or veins with minimal superimposition.

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Cerebral CT angiography using a small volume of concentrated contrast material with a test injection method: optimal scan delay for quantitative and qualitative performance

Abstract: Setting scan delay as [(T(cW)+8)-SD] s can produce the best performance both quantitatively and qualitatively.

Cited by 11 publications

References 19 publications

Intraarterial Injection of Iodinated Contrast Medium for Contrast Enhanced Computed Tomography of the Equine Head

Intraarterial Injection of Iodinated Contrast Medium for Contrast Enhanced Computed Tomography of the Equine Head

Effect of Right-Sided Versus Left-Sided Contrast Injection on Intra-arterial Opacification Characteristics of Head and Neck Computed Tomography Angiograms and Interactions With Patient Sex, Weight, and Cardiac Output

Optimal scan timing for artery–vein separation at whole-brain CT angiography using a 320-row MDCT volume scanner

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