MDCT Angiography of the Pulmonary Arteries: Influence of Body Weight, Body Mass Index, and Scan Length on Arterial Enhancement at Different Iodine Flow Rates

Abstract

Pulmonary artery attenuation in CTA of the pulmonary arteries shows a small but significant correlation with body weight and body mass index independently of the iodine flow rate used. A higher iodine flow rate improves pulmonary artery enhancement.

Contrast Media Administration in Coronary Computed Tomography Angiography – A Systematic Review

“…An increased total CM volume injected at the same flow rate leads to a prolonged injection duration, which increases the magnitude of vascular enhancement. Similarly, injection of a dedicated CM with higher flow rates affects both the magnitude and timing of contrast enhancement, leading to a shorter, earlier and higher peak enhancement and a proportional increase in vascular and parenchymal enhancement [1,4,11,80,81]. A short injection duration might be challenging and requires careful timing of CM bolus injection and data acquisition, especially in patients with abnormal hemodynamic parameters (e. g. irregular heart rate or low/high cardiac output) [74].…”

State-of-the-Art Multi-Detector CT Angiography in Acute Pulmonary Embolism: Technique, Interpretation and Future Perspectives

“…Similarly as with radiation, more iodine is needed in large patients to achieve a comparable opacification of the pulmonary arteries as in a small patient. This can be achieved by either increasing the iodine flow rate (20) or by increasing the total volume of administered contrast medium (21) to overcome the inversely proportional relationship between opacification of the pulmonary arteries and body weight (17). 2.…”

Individually tailored contrast enhancement in CT pulmonary angiography

“…11,13 The enhancement of pulmonary arteries depends on multiple factors: scan technique including tube settings (kV; mAs), scan duration, patient-related factors such as breathing (Valsalva) and body weight as well as contrast media (CM) administration parameters. 11,14,15 Regarding the latter, both the amount of iodine injected per second [iodine delivery rate (IDR)] and the total amount of iodine [total iodine load (TIL)] are important factors in the enhancement of pulmonary arteries. 5,[14][15][16] One of the most influential patient-related factors is body weight; arterial enhancement and body weight have been found to correlate significantly, as well as enhancement and body mass index.…”

“…11,14,15 Regarding the latter, both the amount of iodine injected per second [iodine delivery rate (IDR)] and the total amount of iodine [total iodine load (TIL)] are important factors in the enhancement of pulmonary arteries. 5,[14][15][16] One of the most influential patient-related factors is body weight; arterial enhancement and body weight have been found to correlate significantly, as well as enhancement and body mass index. 14,15 Therefore, fixed CM protocols may result in attenuation values below the diagnostic level for heavier patients, whereas for skinny patients, attenuation may exceed required levels.…”

“…5,[14][15][16] One of the most influential patient-related factors is body weight; arterial enhancement and body weight have been found to correlate significantly, as well as enhancement and body mass index. 14,15 Therefore, fixed CM protocols may result in attenuation values below the diagnostic level for heavier patients, whereas for skinny patients, attenuation may exceed required levels. Therefore, a solution could possibly be found in individualizing contrast application for each patient.…”