Intravenous contrast material administration at 16-detector row helical CT coronary angiography: test bolus versus bolus-tracking technique.

PURPOSE To compare test bolus and bolus-tracking techniques for intravenous contrast material administration at 16-detector row computed tomographic (CT) coronary angiography. MATERIALS AND METHODS This study had institutional review board approval, and patients gave informed consent. Thirty-eight patients (mean age, 60 years; three women) were randomized into two groups according to bolus timing technique: group 1 (20-mL test bolus with 100-mL main bolus) and group 2 (bolus tracking with 100-mL main bolus). All patients underwent electrocardiography-gated 16-detector row CT coronary angiography with 12 detectors (collimation, 0.75 mm; rotation time, 420 msec). In group 1, test bolus peak attenuation was used as a delay, while in group 2, a +100-HU threshold in ascending aorta triggered angiographic acquisition, with an additional 4-second delay for patient instruction. Attenuation was measured in the longitudinal direction throughout the examination in three main vessels: ascending aorta (region of interest [ROI] 1), descending aorta (ROI 2), and main pulmonary artery (ROI 3). Mean attenuation and slope of bolus geometry curve were calculated in each patient and ROI. Attenuation at origin of coronary arteries was measured. Student t test was used to compare results. RESULTS Mean scan delay was 6 seconds longer in group 2 (P < .05). Average attenuation values were 306.6 HU +/- 44.0 (standard deviation) and 328.2 HU +/- 58.6 (P > .05) in ROI 1, 291.6 HU +/- 45.1 and 326.4 HU +/- 62.6 (P > .05) in ROI 2, and 354.7 HU +/- 78.0 and 305.3 HU +/- 71.4 (P < .05) in ROI 3 for groups 1 and 2, respectively. Average slope values were 5.8 and -0.8 (P < .05) in ROI 1, 7.7 and 0.7 (P < .05) in ROI 2, and -1.0 and -13.3 (P < .05) in ROI 3 for groups 1 and 2, respectively. Average attenuation values in left main, left anterior descending, and left circumflex arteries were higher in group 2 (P < .05); there were no differences (P > .05) between groups in right coronary artery. CONCLUSION Bolus-tracking yields more homogeneous enhancement than does the test bolus technique.

[1]  G D Rubin,et al.  Improved uniformity of aortic enhancement with customized contrast medium injection protocols at CT angiography. , 2000, Radiology.

[2]  C. White,et al.  Usefulness of multislice spiral computed tomography angiography for determination of coronary artery stenoses. , 2001, The American journal of cardiology.

[3]  M. Noack,et al.  Optimized enhancement in helical CT: experiences with a real-time bolus tracking system in 628 patients. , 2000, Clinical radiology.

[4]  M. Macari,et al.  Infrarenal abdominal aortic aneurysms at multi-detector row CT angiography: intravascular enhancement without a timing acquisition. , 2001, Radiology.

[5]  P. Serruys,et al.  Usefulness of multislice computed tomography for detecting obstructive coronary artery disease. , 2002, The American journal of cardiology.

[6]  J. Sandstede,et al.  Optimization of automatic bolus tracking for timing of the arterial phase of helical liver CT , 2001, European Radiology.

[7]  Werner Moshage,et al.  Detection of Coronary Artery Stenoses by Contrast-Enhanced, Retrospectively Electrocardiographically-Gated, Multislice Spiral Computed Tomography , 2001, Circulation.

[8]  J. Truebenbach,et al.  Biphasic spiral CT of the liver: automatic bolus tracking or time delay? , 2001, European Radiology.

[9]  A. Kopp,et al.  Darstellung der Herzkranzgefäße im CT mittels neuer 16-Zeilen-Technologie und reduzierter Rotationszeit: Erste Erfahrungen , 2002 .

[10]  M. Prokop.  Multislice CT angiography. , 2000, European journal of radiology.

[11]  Matthijs Oudkerk,et al.  Coronary angiography with multi-slice computed tomography , 2001, The Lancet.

[12]  J Simon,et al.  New Technical Developments in Multislice CT, Part 2: Sub-Millimeter 16-Slice Scanning and Increased Gantry Rotation Speed for Cardiac Imaging , 2002, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[13]  J. Truebenbach,et al.  Automatic bolus tracking in monophasic spiral CT of the liver: liver-to-lesion conspicuity , 2001, European Radiology.

[14]  J A Brink,et al.  Aortic and hepatic peak enhancement at CT: effect of contrast medium injection rate--pharmacokinetic analysis and experimental porcine model. , 1998, Radiology.

[15]  Giacomo Luccichenti,et al.  Parameters affecting bolus geometry in CTA: a review. , 2002, Journal of computer assisted tomography.

[16]  Werner Moshage,et al.  Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT. , 2000 .

[17]  W. Bautz,et al.  Detection of Coronary Artery Stenoses With Thin-Slice Multi-Detector Row Spiral Computed Tomography and Multiplanar Reconstruction , 2003, Circulation.

[18]  E Grabbe,et al.  Dual-phase helical CT of the liver: effects of bolus tracking and different volumes of contrast material. , 1996, Radiology.

[19]  J Simon,et al.  New technical developments in multislice CT , 2002, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[20]  K. Engelmann,et al.  Techniques for the detection of coronary atherosclerosis: multi-detector row CT coronary angiography. , 2002, Radiology.

[21]  Pedro A. Lemos,et al.  Reliable Noninvasive Coronary Angiography With Fast Submillimeter Multislice Spiral Computed Tomography , 2002, Circulation.