Contrast dose reduction with shortened injection durations in coronary CT angiography on 16-cm Wide-detector CT scanner

Br J Radiol. 2018 Dec;91(1092):20180580. doi: 10.1259/bjr.20180580. Epub 2018 Sep 4.

Abstract

Objectives:: To investigate the use of shortened contrast injection with late triggering in coronary CT angiography (CCTA) for decreasing contrast dose and maintaining image quality.

Methods:: 106 patients for CCTA on a 16-cm wide-detector CT were prospectively enrolled into groups A (n = 50) and B (n = 56) randomly. Patient weight-dependent contrast medium (Iopamiro, 370 mgI ml-1) at dose rate of 25 mgI/kg/s was used with 8 s and the standard 10 s injection time in groups A and B, respectively. CT values of the aortic sinus (AS), right coronary artery, left anterior descending and left circumflex at the proximal, middle and distal segments were measured and compared. Subjective image quality was evaluated and analyzed with Fisher exact test. Contrast dose, injection rate and enhancement duration (between the start of enhancement in AS and scan finish) were also compared.

Results:: There was no difference in the injection rate and enhancement duration between the two groups (p > 0.05), while the total contrast dose in group A (36.2 ± 5.7 ml) was significantly lower than in group B (46.4 ± 6.3 ml) (p < 0.001). There was no difference for CT values in all major coronary vessels between the two groups and no difference in subjective image quality scores (all p > 0.05).

Conclusion:: It is feasible to shorten contrast injection to 8 s in CCTA on wide-detector CT systems to significantly reduce contrast dosage, maintain adequate enhancement and reduce contrast-related artifacts.

Advances in knowledge:: (1) Coronary CT angiography (CCTA) scans with shortened contrast medium injection duration and late triggering are feasible with a 16-cm wide-detector CT system (2) Compared with the conventional CCTA with 10 s contrast injection duration, the new contrast injection protocol of using shortened injection duration (to 8 s) and late triggering reduces contrast dose to 36.2 ml, while maintaining adequate enhancement in vessels and reducing contrast-related artifacts.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Artifacts
  • Computed Tomography Angiography / methods*
  • Contrast Media / administration & dosage*
  • Coronary Angiography / methods*
  • Coronary Vessels / diagnostic imaging*
  • Female
  • Humans
  • Injections, Intravenous
  • Iopamidol / administration & dosage*
  • Male
  • Middle Aged
  • Prospective Studies

Substances

  • Contrast Media
  • Iopamidol