Contrast Enhancement in Cardiovascular MDCT: Effect of Body Weight, Height, Body Surface Area, Body Mass Index, and Obesity

Abstract

To achieve a consistent contrast enhancement in cardiac CT angiography (CTA), contrast-medium dose should be adjusted with the body weight or the BSA (which accounts for both the body weight and height factors) to provide adjustment of iodine dose over a wide range of body sizes.

Determinants of vessel contrast in BMI-adapted low dose CT coronary angiography with prospective ECG-triggering

“…This may explain why BSA, reflecting CO and blood volume was slightly closer correlated to attenuation than CO alone. It has therefore been theoretically suggested that contrast medium should be adjusted to BSA [9]. Our study confirms a close relationship between BSA and attenuation.…”

“…CTCA image quality is impaired in patients with high BMI due to increased image noise and decreased coronary attenuation [9][10][11]13]. In the present study we have minimized the impact of BMI on image noise, supporting that the adjustment of tube voltage and current was appropriate.…”

“…First, the amount of contrast material was not BMI-adapted in concordance with a large body of literature [1][2][3][4]6,8], although suggested by a few previous reports [9,10]. However, only the use of a fixed amount of contrast material enabled us to specifically evaluate the influence of BMI on image noise and coronary vessel attenuation.…”

“…According to previous studies, an increase in BMI induces higher image noise [9][10][11] while an increase in CO is associated with a decrease in coronary artery contrast [13]. The latter is most probably caused by more contrast dilution in coronary arteries.…”

“…body mass index (BMI), body surface area (BSA)) [9][10][11] or by contrast bolus dilution depending on cardiac output (CO) [12][13][14]. Coronary calcifications are known to influence image quality by their blooming and beam-hardening artifacts [1,4,7].…”