APPLICATION OF CT PULMONARY ANGIOGRAPHY WITH "ULTRA-DOUBLE-LOW" AND ITERATIVE MODEL RECONSTRUCTION FOR ACUTE PULMONARY EMBOLISM

Abstract

The study is to investigate the feasibility of computed tomography pulmonary angiography (CTPA) with iterative model reconstruction (IMR) and "Ultra-double-low" (Ultra-low dose, Ultra-low contrast agent volume). Thirty-six patients who tested positive for pulmonary embolism in CTPA were enrolled in the study. Another CTPA was performed 1 week after thrombolytic therapy. The first examination was routine CTPA (Routine Group) with the parameters as follows: automatic mA scanning, 120 kV and image reconstruction by using iDose4 iterative reconstruction (Lever 4), iodine concentration and dose of contrast agent: 300 mgI/ml and 0.5 gI/kg, respectively. The latter one was ultra-low dose CTPA examination (Ultra-low Group): 40 mAs, 80 kV and IMR (Lever 3), contrast agent: 300 mgI/ml and 15 mL, respectively. Effective dose (ED), CT dose index volume (CTDIvol), dose length product (DLP), attenuation of pulmonary artery, contrast noise ratio (CNR) and signal noise ratio (SNR) were recorded and calculated. The imaging qualities were subjectively assessed. The Eds/CTDIvols/DLPs of Ultra-low Group are lower than the Routine Group (P < 0.05). The differences in attenuation between the two groups are not significant (P > 0.05). The differences in CNR and SNR between the two groups are significant (P < 0.05). The differences in imaging qualities between the two groups when subjectively assessed are not significant (P > 0.05). The 256-slice spiral CT combined with IMR and "Ultra-double-low" is feasible for the acute pulmonary embolism examination and the radiation dose and the volume of contrast agent can be greatly reduced.