Improving Contrast Enhancement in Pulmonary CTA: The value of breathing maneuvers.
ANOVA, analysis of variances
Breathing
Computed tomography angiography
Contrast density
GCP, good clinical practice
ICC, intraclass correlation coefficient
IDR, iodine delivery rate
IRB, institutional review board
IVC, inferior vena cava
Image quality
MPR, multiplanar reformations
PE, pulmonary embolism
Pulmonary arteries
Pulmonary embolism
ROI, region of interest
SVC, superior vena cava
pCTA, pulmonary computed tomography angiography
Journal
European journal of radiology open
ISSN: 2352-0477
Titre abrégé: Eur J Radiol Open
Pays: England
ID NLM: 101650225
Informations de publication
Date de publication:
2020
2020
Historique:
received:
07
08
2020
revised:
03
10
2020
accepted:
06
10
2020
entrez:
26
10
2020
pubmed:
27
10
2020
medline:
27
10
2020
Statut:
epublish
Résumé
To investigate contrast dynamics and artifacts associated with different breathing maneuvers during pulmonary computed tomography angiography (pCTA) in a prospective randomized clinical trial. Three different breathing maneuvers (inspiration, expiration, Mueller) were randomly assigned to 146 patients receiving pCTA for suspected pulmonary embolism (PE). Contrast enhancement of central and peripheral arteries and imaging quality of lung parenchyma were compared and analyzed. Results were compared by using the analysis of variances (ANOVA) and Kruskal-Wallis-Test. Mean enhancement in the pulmonary trunk was highest during breath-hold in inspiration (293 HU, range 195-460 HU) compared to Mueller (259 HU, range 136-429 HU, p = 0022) and expiration (267 HU, range 115-376 HU). This was similar for the right pulmonary artery (inspiration 289 HU, range 173-454 HU; Mueller 250 HU, range 119-378 HU; p = 0.007; expiration 257 HU, range 114-366 HU; p = 0.032) and left pulmonary artery (inspiration 280.3 HU, range 170-462 HU; Mueller 245 HU, range 111-371 HU; p = 0.016; expiration 252 HU, range 110-371 HU).Delineation of peripheral arteries was significantly better in inspiration vs Mueller (p = 0.006) and expiration (p = 0.049). Assessment of the lung parenchyma was significantly better in inspiration vs Mueller (p = 0.013) or expiration (p < 0.001). Resting inspiratory position achieved the highest enhancement levels in central and peripheral pulmonary arteries and best image quality of the pulmonary parenchyma in comparison to other breathing maneuvers. It is necessary to train the maneuver prior to the examination in order to avoid deep inspiration with the risk of suboptimal opacification of the pulmonary arteries.
Identifiants
pubmed: 33102639
doi: 10.1016/j.ejro.2020.100280
pii: S2352-0477(20)30069-1
pmc: PMC7578205
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100280Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2020 The Authors.
Déclaration de conflit d'intérêts
The authors report no declarations of interest.
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