Influence of osmolarity of contrast medium and saline flush on computed tomography angiography: Comparison of monomeric and dimeric iodinated contrast media with different iodine concentrations at an identical iodine delivery rate

Kishimoto, Miori; Doi, Shoko; Shimizu, Junichiro; Lee, Kija; Iwasaki, Tadaaki; Miyake, Yoh‐Ichi; Yamada, Kazutaka

doi:10.1016/j.ejrad.2009.05.018

Cited by 8 publications

(13 citation statements)

References 14 publications

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“…Finally, we compared two contrast materials with different molecular structures (monomeric vs dimeric). Although this could have partly affected our results, recent data in an animal model showed only a negligible effect of the contrast material molecular structure on the contrast enhancement of the thoracic aorta [31].…”

Section: Effect Of Contrast Materials Iodine Concentrations During LIVcontrasting

confidence: 41%

Effect of varying contrast material iodine concentration and injection technique on the conspicuity of hepatocellular carcinoma during 64-section MDCT of patients with cirrhosis

Guerrisi

Marin

Nelson

et al. 2011

BJR

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Objectives: The aim of this study was to compare the intraindividual effects of contrast material with two different iodine concentrations on the conspicuity of hepatocellular carcinoma (HCC) and vascular and hepatic contrast enhancement during multiphasic, 64-section multidetector row CT (MDCT) in patients with cirrhosis using two contrast medium injection techniques. Methods: Patients were randomly assigned to one of two groups with an equal iodine dose but different contrast material injection techniques: scheme A, fixed injection duration (25 s), and scheme B, fixed injection flow rate (4 ml s 21). For each group, patients were randomised to receive both moderate-concentration contrast medium (MCCM) and high-concentration contrast medium (HCCM) during two CT examinations within 3 months. Enhancement of the aorta, liver and portal vein and the tumour-toliver contrast-to-noise ratio (CNR) were compared between MCCM and HCCM. Results: 30 patients (mean age 59 years; range 45-80 years; 16 patients in scheme A and 14 in scheme B) with a total of 31 confirmed HCC nodules were prospectively enrolled. For scheme B, the mean contrast enhancement of the aorta and tumour-to-liver CNR were significantly higher with HCCM than with MCCM during the hepatic arterial phase (+350.5 HU vs +301.1 HU, p50.001, and +7.5 HU vs +5.5 HU, p50.004). For both groups, there was no significant difference between MCCM and HCCM for all other comparisons. Conclusion: For a constant injection flow rate, HCCM significantly improves the conspicuity of HCC lesions and aortic enhancement during the hepatic arterial phase on 64-section MDCT in patients with cirrhosis. Along with MRI, multidetector row CT (MDCT) is the modality of choice for the diagnosis and follow-up of patients with hepatocellular carcinoma (HCC), as well as for tumour burden assessment. With the advent of volume MDCT, enabling the acquisition of 64 or more sections during a single gantry rotation, it has become possible to scan the entire abdomen with submillimetre section widths within a short scan time (less than 5 s for 300 mm of coverage). Although this technique has shown several advantages over conventional CT, including better discrimination between different circulatory phases, the potential for scanning during peak organ enhancement throughout the entire imaging volume and true isotropic CT data sets, it has raised considerable challenges for the design of scanning and contrast material injection protocols that are optimised for the detection of hypervascular HCC lesions [1]. Recent investigations have emphasised the importance of using test bolus or bolus-tracking methods to synchronise CT data acquisition with the peak tumourto-liver contrast for hypervascular HCC lesions [2,3]; however, the most effective contrast medium injection technique for maximising tumour enhancement during the narrow temporal acquisition of modern MDCT systems remains largely unexplored. Previous studies with early generation MDCT scanners reported conflicting results with varying volumes a...

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Section: Effect Of Contrast Materials Iodine Concentrations During LIVcontrasting

confidence: 41%

Effect of varying contrast material iodine concentration and injection technique on the conspicuity of hepatocellular carcinoma during 64-section MDCT of patients with cirrhosis

Guerrisi

Marin

Nelson

et al. 2011

BJR

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“…Furthermore, iodixanol was compared with high‐iodine CM with corresponding high viscosity (e.g. with iodine concentrations of 350 or 370 mg iodine), resulting in a worse flow pattern 5–7,15 …”

Section: Discussionmentioning

confidence: 99%

“…with iodine concentrations of 350 or 370 mg iodine), resulting in a worse flow pattern. [5][6][7]15 Nephrotoxicity of CM and especially the renal safety of iodixanol is an ongoing topic of many studies. [16][17][18][19] Previously published meta-analysis reported that iodixanol did not significantly reduce the risk of contrast mediuminduced nephropathy (CIN) compared with all tested low-osmolar CM pooled together, excluding iohexol and ioxaglate.…”

Section: Discussionmentioning

confidence: 99%

Low‐osmolar monomeric versus iso‐osmolar dimeric contrast media: An intra‐individual comparison in CT angiography using an animal model

Behrendt¹,

Pietsch

Jošt

et al. 2011

J Med Imag Rad Onc

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“…Thus, the higher the viscosity, the stronger the vasodilatation, the higher the flow (24). However this effect has not been demonstrated to be significantly influent on enhancement (26). In the microcirculation viscosity is mainly influenced by cells deformation, frictional contact and tendency to aggregate.…”

Section: Contrast Medium Osmolarity and Viscositymentioning

confidence: 99%

The optimal contrast media policy in CT of the liver. Part I: Technical notes

Rengo¹,

Bellini²,

Cecco³

et al. 2011

Acta Radiol

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Latest developments of multidetector computed tomography (MDCT), which is today considered a real volumetric technique, have revolutionized abdominal imaging. Technological improvements such as higher spatial resolution, larger volume coverage and higher temporal resolution, have reduced scan times allowing CT studies of the abdomen within a single breath-hold. Furthermore, the increased number of slices, the submillimetric collimation, and the use of multiple dynamic post-contrast phases per single examination, may all contribute to increase the radiation exposure of single patients. The aim of this review is to discuss different parameters affecting contrast media enhancement, as vascular enhancement, parenchymal enhancement and timing, in order to minimize the amount of contrast medium injected and the radiation exposure

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Influence of osmolarity of contrast medium and saline flush on computed tomography angiography: Comparison of monomeric and dimeric iodinated contrast media with different iodine concentrations at an identical iodine delivery rate

Cited by 8 publications

References 14 publications

Effect of varying contrast material iodine concentration and injection technique on the conspicuity of hepatocellular carcinoma during 64-section MDCT of patients with cirrhosis

Effect of varying contrast material iodine concentration and injection technique on the conspicuity of hepatocellular carcinoma during 64-section MDCT of patients with cirrhosis

Low‐osmolar monomeric versus iso‐osmolar dimeric contrast media: An intra‐individual comparison in CT angiography using an animal model

The optimal contrast media policy in CT of the liver. Part I: Technical notes

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