Paradoxical Effect of Cardiac Output on Arterial Enhancement at Computed Tomography: Does Cardiac Output Reduction Simply Result in an Increase in Aortic Peak Enhancement?

J Comput Assist Tomogr. 2017 May/Jun;41(3):349-353. doi: 10.1097/RCT.0000000000000541.

Abstract

Objective: The aim of this study was to evaluate the effect of cardiac output (CO) on aortic peak enhancement using protocols with different contrast material (CM) injection durations.

Methods: We used a flow phantom that simulated the human circulatory system. Contrast material was injected at a rate of 4.0 mL/s for a period of 2.5, 5, 10, 15, or 20 seconds for a CO of 2.8, 4.2, and 5.6 L/min. Single-level serial computed tomography scans of the simulated aorta were acquired after the start of CM delivery, and aortic peak enhancement was recorded under the different injection protocols.

Results: Under a long injection duration protocol (20 seconds), a decrease in CO increased aortic peak enhancement proportionally (CO of 2.8 L/min, 420 Hounsfield units [HU]; CO of 4.2 L/min, 365 HU; CO of 5.6 L/min, 291 HU). However, this effect was decreased under shorter injection duration protocols (5, 10, and 15 seconds); under the shortest (2.5-second) injection duration protocol, a decrease in CO resulted in a decrease in aortic peak enhancement (CO of 2.8 L/min, 36 HU; CO of 4.2 L/min, 51 HU; CO of 5.6 L/min, 55 HU).

Conclusions: The magnitude of the effect of CO on aortic peak enhancement depends on the CM injection duration.

MeSH terms

  • Aorta / physiology
  • Cardiac Output / physiology*
  • Contrast Media / administration & dosage*
  • Iopamidol / administration & dosage*
  • Phantoms, Imaging
  • Radiographic Image Enhancement / methods*
  • Time Factors
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media
  • Iopamidol