Purpose
To investigate enhancement of extra- and intra-cranial arteries during carotid CTA using a novel acquisition/contrast regimen.
Methods and Materials
Carotid CTA was performed in 202 patients with stroke like symptoms using a 64 channel computed tomography scanner (VCT,GE,
Connecticut) and a dual barrel contrast injector (Stellant,
Medrad,
Pennsylvania).
Patients were subjected in equal numbers to one of two acquisition/contrast regimen.
Patient age and gender were equally distributed across both groups.
Regimen A,
the department’s standard protocol,
consisted of a caudocranial scan direction with 100mL of contrast (Ultravist 370 mgI/mL; Schering,
Germany),
intravenously injected at a flow rate (FR) of 4.5 mL/s; Regimen B,
involved...
Results
Median vessel opacification in the ascending aorta,
all carotid and vertebral vessels and all measured intracranial arteries were up to 56% (p <0.01) higher following regimen B compared with A.
In the venous system,
attenuation within transverse sinus,
internal jugular,
brachiocephalic and superior vena cava veins were significantly lower in regimen B than in regimen A with a maximum reduction of up to 90% (p <0.0001).
Further analyses demonstrated significant improvements in AVCR (p <0.0001) at the level of transverse sinus (72%),
foramen magnum (70%),...
Conclusion
A novel acquisition/contrast regimen is presented that demonstrates significant improvements in visualisation of head and neck arterial vasculature,
whilst reducing risks of adverse contrast reactions.
Clinically Practiced and Viable Contrast Formula - 4000 cases to date
Increased vessel opacification (p < 0.0001) up to 54 %
Reduction of Venous opacification (p < 0.0001) up to 93 %
AVCR - Significant (p <0.0001) improvement up to 95 %.
Contrast Volume reduction average 47 %
Complete utilisation of the Contrast Bolus irrespective of patient variables
Clinical viability...
References
1 Aging AGDoHa (2011) Medicare Benefits Schedule Item Statistics Reports.
Medicare Australia
2 Bader BD,
Berger ED,
Heede MB,
et al.
(2004) What is the best hydration regimen to prevent contrast media-induced nephrotoxicity? Clin Nephrol,
62(1):1-7
3 Briguori C,
Manganelli F,
Scarpato P,
et al.
(2002) Acetylcysteine and contrast agent-associated nephrotoxicity.
J Am Coll Cardiol,
40(2):298-303
4 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(2):178-183
5 Chen CJ,
Tseng...
Personal Information
Contact Information;
Charbel Saade
Royal Prince Alfred Hospital,
Sydney Australia
E:
[email protected]
W: www.
mdct.com.au
