nach oben

European Radiology

Erschienen in:

01.06.2014 | Cardiac

Contrast agent bolus tracking with a fixed threshold or a manual fast start for coronary CT angiography

verfasst von: Fabian Stenzel, Matthias Rief, Elke Zimmermann, Johannes Greupner, Felicitas Richter, Marc Dewey

Erschienen in: European Radiology | Ausgabe 6/2014

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Comparison of bolus tracking with a fixed threshold versus a manual fast start for coronary CT angiography.

Methods

We retrospectively analysed 320-row coronary CT angiography of 50 patients with suspected or known coronary artery disease. Twenty-five examinations were initiated by a bolus tracking method (group 1), 25 examinations with a manual fast surestart (group 2).

Results

Mean attenuation values in the ascending aorta were 519 ± 111 Hounsfield units (HU) in group 1 and 476 ± 65 HU in group 2 (p = 0.10). Assessable vessel lengths were 171 ± 44 mm vs 172 ± 29 mm for the right coronary artery (p = 0.91), 11 ± 4 mm vs 12 ± 4 mm for the left main (p = 0.9), 163 ± 28 mm vs 151 ± 26 mm for the left anterior descending coronary artery (p = 0.11) and 125 ± 41 mm vs 110 ± 37 mm for the left circumflex coronary artery (p = 0.18). Image quality for all coronary arteries was not significantly different between the groups (p > 0.41). The attenuation ratio between the left and right ventricle was 2.8 ± 0.7 vs 3.6 ± 1.0 (p = 0.003). Significantly less contrast agent was used in group 2 (64 ± 6 ml vs 80 ± 0 ml; p < 0.001).

Conclusions

Bolus tracking with a fixed threshold and with a manual fast start are both suitable methods; the fast start allowed a reduction of contrast agent volumes.

Key Points

• Fixed threshold bolus tracking is suitable for coronary 320-row CT angiography

• Manual fast start bolus tracking can reduce contrast agent volumes

• Manual fast start and fixed threshold initiation achieve good image quality

• Fixed threshold bolus tracking achieves a more reliable contrast bolus position

Schuetz GM, Zacharopoulou NM, Schlattmann P, Dewey M (2010) Meta-analysis: noninvasive coronary angiography using computed tomography versus magnetic resonance imaging. Ann Intern Med 152:167–177PubMedCrossRef

Miller JM, Rochitte CE, Dewey M et al (2008) Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med 359:2324–2336PubMedCrossRef

Hamon M, Biondi-Zoccai GG, Malagutti P, Agostoni P, Morello R, Valgimigli M (2006) Diagnostic performance of multislice spiral computed tomography of coronary arteries as compared with conventional invasive coronary angiography: a meta-analysis. J Am Coll Cardiol 48:1896–1910PubMedCrossRef

Leschka S, Alkadhi H, Plass A et al (2005) Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J 26:1482–1487PubMedCrossRef

de Graaf FR, Schuijf JD, van Velzen JE et al (2010) Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasive evaluation of significant coronary artery disease. Eur Heart J 31:1908–1915PubMedCrossRef

Budoff MJ, Dowe D, Jollis JG et al (2008) Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol 52:1724–1732PubMedCrossRef

Dewey M, Borges AC, Kivelitz D et al (2004) Coronary artery disease: new insights and their implications for radiology. Eur Radiol 14:1048–1054PubMedCrossRef

Johnson TR, Nikolaou K, Wintersperger BJ et al (2006) Dual-source CT cardiac imaging: initial experience. Eur Radiol 16:1409–1415PubMedCrossRef

Klass O, Walker M, Siebach A et al (2010) Prospectively gated axial CT coronary angiography: comparison of image quality and effective radiation dose between 64- and 256-slice CT. Eur Radiol 20:1124–1131PubMedCrossRef

10.

Pugliese F, Mollet NR, Runza G et al (2006) Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris. Eur Radiol 16:575–582PubMedCrossRef

11.

Leschka S, Wildermuth S, Boehm T et al (2006) Noninvasive coronary angiography with 64-section CT: effect of average heart rate and heart rate variability on image quality. Radiology 241:378–385PubMedCrossRef

12.

Dewey M, Teige F, Laule M, Hamm B (2007) Influence of heart rate on diagnostic accuracy and image quality of 16-slice CT coronary angiography: comparison of multisegment and halfscan reconstruction approaches. Eur Radiol 17:2829–2837PubMedCrossRef

13.

Dewey M, Vavere AL, Arbab-Zadeh A et al (2010) Patient characteristics as predictors of image quality and diagnostic accuracy of MDCT compared with conventional coronary angiography for detecting coronary artery stenoses: CORE-64 Multicenter International Trial. AJR Am J Roentgenol 194:93–102PubMedCentralPubMedCrossRef

14.

Schnapauff D, Teige F, Hamm B, Dewey M (2009) Comparison between the image quality of multisegment and halfscan reconstructions of non-invasive CT coronary angiography. Br J Radiol 82:969–975PubMedCentralPubMedCrossRef

15.

Tomizawa N, Nojo T, Akahane M, Torigoe R, Kiryu S, Ohtomo K (2013) Shorter delay time reduces interpatient variability in coronary enhancement in coronary CT angiography using the bolus tracking method with 320-row CT. Int J Cardiovasc Imaging. doi:10.1007/s10554-012-0045-1

16.

Cademartiri F, de Monye C, Pugliese F et al (2006) High iodine concentration contrast material for noninvasive multislice computed tomography coronary angiography: iopromide 370 versus iomeprol 400. Invest Radiol 41:349–353PubMedCrossRef

17.

Cademartiri F, Mollet NR, van der Lugt A et al (2005) Intravenous contrast material administration at helical 16-detector row CT coronary angiography: effect of iodine concentration on vascular attenuation. Radiology 236:661–665PubMedCrossRef

18.

Cademartiri F, van der Lugt A, Luccichenti G, Pavone P, Krestin GP (2002) Parameters affecting bolus geometry in CTA: a review. J Comput Assist Tomogr 26:598–607PubMedCrossRef

19.

Lell M, Marwan M, Schepis T et al (2009) Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience. Eur Radiol 19:2576–2583PubMedCrossRef

20.

Seifarth H, Puesken M, Kalafut JF et al (2009) Introduction of an individually optimized protocol for the injection of contrast medium for coronary CT angiography. Eur Radiol 19:2373–2382PubMedCrossRef

21.

Tomizawa N, Nojo T, Akahane M, Torigoe R, Kiryu S, Ohtomo K (2012) Prediction of the attenuation of the ascending aorta using bolus-tracking parameters and heart rate in coronary computed tomography angiography. Eur J Radiol. doi:10.1016/j.ejrad.2012.02.001

22.

Bae KT (2010) Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology 256:32–61PubMedCrossRef

23.

Rybicki FJ, Otero HJ, Steigner ML et al (2008) Initial evaluation of coronary images from 320-detector row computed tomography. Int J Cardiovasc Imaging 24:535–546PubMedCrossRef

24.

de Graaf FR, Schuijf JD, van Velzen JE et al (2010) Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography to noninvasively assess in-stent restenosis. Invest Radiol 45:331–340PubMed

25.

Dewey M, Muller M, Teige F, Hamm B (2006) Evaluation of a semiautomatic software tool for left ventricular function analysis with 16-slice computed tomography. Eur Radiol 16:25–31PubMedCrossRef

26.

Dewey M (2013) Coronary artery disease management using multislice computed tomography and magnetic resonance imaging. http://www.clinicaltrials.gov/ct2/show/study/NCT00844220. Accessed 6 Sept 2013

27.

Dewey M, Zimmermann E, Deissenrieder F et al (2009) Noninvasive coronary angiography by 320-row computed tomography with lower radiation exposure and maintained diagnostic accuracy: comparison of results with cardiac catheterization in a head-to-head pilot investigation. Circulation 120:867–875PubMedCrossRef

28.

Dewey M, Hoffmann H, Hamm B (2006) Multislice CT coronary angiography: effect of sublingual nitroglycerine on the diameter of coronary arteries. Rofo 178:600–604PubMedCrossRef

29.

Dewey M, Schnapauff D, Laule M et al (2004) Multislice CT coronary angiography: evaluation of an automatic vessel detection tool. Rofo 176:478–483PubMedCrossRef

30.

Zhu X, Chen W, Li M et al (2012) Contrast material injection protocol with the flow rate adjusted to the heart rate for dual source CT coronary angiography. Int J Cardiovasc Imaging 28:1557–1565PubMedCrossRef

31.

Becker CR, Hong C, Knez A et al (2003) Optimal contrast application for cardiac 4-detector-row computed tomography. Invest Radiol 38:690–694PubMedCrossRef

32.

Yang WJ, Chen KM, Liu B et al (2013) Contrast media volume optimization in high-pitch dual-source CT coronary angiography: feasibility study. Int J Cardiovasc Imaging 29:245–252PubMedCrossRef

33.

La Grutta L, Galia M, Gentile G et al (2013) Comparison of iodinated contrast media for the assessment of atherosclerotic plaque attenuation values by CT coronary angiography: observations in an ex vivo model. Br J Radiol 86:20120238PubMedCrossRef

34.

35.

Mühlenbruch G, Behrendt F, Eddahabi M et al (2008) Which iodine concentration in chest CT? – A prospective study in 300 patients. Eur Radiol 18:2826–2832PubMedCrossRef

36.

Rubin GD, Lane MJ, Bloch DA, Leung AN, Stark P (1996) Optimization of thoracic spiral CT: effects of iodinated contrast medium concentration. Radiology 201:785–791PubMed

37.

Cademartiri F, Nieman K, van der Lugt A et al (2004) Intravenous contrast material administration at 16-detector row helical CT coronary angiography: test bolus versus bolus-tracking technique. Radiology 233:817–823PubMedCrossRef

38.

Ramos-Duran LR, Kalafut JF, Hanley M, Schoepf UJ (2010) Current contrast media delivery strategies for cardiac and pulmonary multidetector-row computed tomography angiography. J Thorac Imaging 25:270–277PubMedCrossRef

39.

Johnson TR, Nikolaou K, Wintersperger BJ et al (2007) Optimization of contrast material administration for electrocardiogram-gated computed tomographic angiography of the chest. J Comput Assist Tomogr 31:265–271PubMedCrossRef

40.

Cademartiri F, Mollet NR, Lemos PA et al (2006) Higher intracoronary attenuation improves diagnostic accuracy in MDCT coronary angiography. AJR Am J Roentgenol 187:W430–433PubMedCrossRef

41.

Fei X, Du X, Yang Q et al (2008) 64-MDCT coronary angiography: phantom study of effects of vascular attenuation on detection of coronary stenosis. AJR Am J Roentgenol 191:43–49PubMedCrossRef

42.

Tonino PA, De Bruyne B, Pijls NH et al (2009) Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med 360:213–224PubMedCrossRef

43.

De Bruyne B, Pijls NH, Kalesan B et al (2012) Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. N Engl J Med 367:991–1001PubMedCrossRef

44.

Min JK, Leipsic J, Pencina MJ et al (2012) Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. JAMA 308:1237–1245PubMedCrossRef

45.

Yoon YE, Choi JH, Kim JH et al (2012) Noninvasive diagnosis of ischemia-causing coronary stenosis using CT angiography: diagnostic value of transluminal attenuation gradient and fractional flow reserve computed from coronary CT angiography compared to invasively measured fractional flow reserve. JACC Cardiovasc Imaging 5:1088–1096PubMedCrossRef

46.

Koo BK, Erglis A, Doh JH et al (2011) Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) study. J Am Coll Cardiol 58:1989–1997PubMedCrossRef

47.

Steigner ML, Mitsouras D, Whitmore AG et al (2010) Iodinated contrast opacification gradients in normal coronary arteries imaged with prospectively ECG-gated single heart beat 320-detector row computed tomography. Circ Cardiovasc Imaging 3:179–186PubMedCentralPubMedCrossRef

48.

Choi JH, Koo BK, Yoon YE et al (2012) Diagnostic performance of intracoronary gradient-based methods by coronary computed tomography angiography for the evaluation of physiologically significant coronary artery stenoses: a validation study with fractional flow reserve. Eur Heart J Cardiovasc Imaging 13:1001–1007PubMedCrossRef

49.

Choi JH, Min JK, Labounty TM et al (2011) Intracoronary transluminal attenuation gradient in coronary CT angiography for determining coronary artery stenosis. JACC Cardiovasc Imaging 4:1149–1157PubMedCrossRef

50.

Wong DT, Ko BS, Cameron JD et al (2013) Transluminal attenuation gradient in coronary computed tomography angiography is a novel noninvasive approach to the identification of functionally significant coronary artery stenosis: a comparison with fractional flow reserve. J Am Coll Cardiol 61:1271–1279PubMedCrossRef

51.

Cademartiri F, Mollet N, van der Lugt A et al (2004) Non-invasive 16-row multislice CT coronary angiography: usefulness of saline chaser. Eur Radiol 14:178–183PubMedCrossRef

52.

Kim DJ, Kim TH, Kim SJ et al (2008) Saline flush effect for enhancement of aorta and coronary arteries at multidetector CT coronary angiography. Radiology 246:110–115PubMedCrossRef

Titel: Contrast agent bolus tracking with a fixed threshold or a manual fast start for coronary CT angiography
verfasst von: Fabian Stenzel
Matthias Rief
Elke Zimmermann
Johannes Greupner
Felicitas Richter
Marc Dewey
Publikationsdatum: 01.06.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 6/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3148-3

Neu im Fachgebiet Radiologie

18.04.2024 | Pädiatrische Notfallmedizin | Nachrichten

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Contrast agent bolus tracking with a fixed threshold or a manual fast start for coronary CT angiography

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Neu im Fachgebiet Radiologie

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Studie bestätigt Potenzial von KI in der Radiologie

Update Radiologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2014

Diagnostic accuracy of segmental enhancement inversion for diagnosis of renal oncocytoma at biphasic contrast enhanced CT: systematic review

Comparison of ASL and DCE MRI for the non-invasive measurement of renal blood flow: quantification and reproducibility

MRI-only lesions: application of diffusion-weighted imaging obviates unnecessary MR-guided breast biopsies

Ultrasound point shear wave elastography assessment of liver and spleen stiffness: effect of training on repeatability of measurements

Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

Effective dose to patient measurements in flat-detector and multislice computed tomography: a comparison of applications in neuroradiology

Neu im Fachgebiet Radiologie

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Studie bestätigt Potenzial von KI in der Radiologie

Update Radiologie