Faculty of Pharmacy and Medicine, University of Rome Sapienza, Latina, Italy.
Departments of Radiology and Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Eur Radiol. 2019 Nov;29(11):6109-6118. doi: 10.1007/s00330-019-06196-7. Epub 2019 Apr 23.
To compare the effect of contrast medium iodine concentration on contrast enhancement, heart rate, and injection pressure when injected at a constant iodine delivery rate in coronary CT angiography (CTA).
One thousand twenty-four patients scheduled for coronary CTA were prospectively randomized to receive one of four contrast media: iopromide 300 mg I/ml, iohexol 350 mg I/ml, iopromide 370 mg I/ml, or iomeprol 400 mg I/ml. Contrast media were delivered at an equivalent iodine delivery rate of 2.0 g I/s. Intracoronary attenuation was measured and compared (per vessel and per segment). Heart rate before and after contrast media injection was documented. Injection pressure was recorded (n = 403) during contrast medium injection and compared between groups.
Intracoronary attenuation values were similar for the different contrast groups. The mean attenuation over all segments ranged between 384 HU for 350 mg I/ml and 395 HU for 400 mg I/ml (p = 0.079). Dose-length product (p = 0.8424), signal-to-noise ratio (all p > 0.05), time to peak (p = 0.324), and changes in heart rate (p = 0.974) were comparable between groups. The peak pressures differed: 197.4 psi for 300 mg I/ml (viscosity 4.6 mPa s), 229.8 psi for 350 mg I/ml (10.4 mPa s), 216.1 psi for 370 mg I/ml (9.5 mPa s), and 243.7 psi for 400 mg I/ml (12.6 mPa s) (p < 0.0001).
Intravascular attenuation and changes in heart rate are independent of iodine concentration when contrast media are injected at the same iodine delivery rate. Differences in injection pressures are associated with the viscosity of the contrast media.
• The contrast enhancement in coronary CT angiography is independent of the iodine concentration when contrast media are injected at body temperature (37 °C) with the same iodine delivery rate. • Iodine concentration does not influence the change in heart rate when contrast media are injected at identical iodine delivery rates. • For a fixed iodine delivery rate and contrast temperature, the viscosity of the contrast medium affects the injection pressure.
在冠状动脉 CT 血管造影（CTA）中以恒定碘输送率注射时，比较不同碘浓度对比剂对对比增强、心率和注射压力的影响。
前瞻性随机将 1024 名拟行冠状动脉 CTA 的患者分为四组，分别接受以下四种对比剂之一：碘普罗胺 300mg I/ml、碘海醇 350mg I/ml、碘普罗胺 370mg I/ml 或碘美普尔 400mg I/ml。以 2.0g I/s 的等效碘输送率输送对比剂。测量并比较冠状动脉内衰减值（按血管和节段）。记录注射对比剂前后的心率。记录 403 例患者在注射对比剂期间的注射压力，并比较组间差异。
不同对比剂组的冠状动脉内衰减值相似。所有节段的平均衰减值在 350mg I/ml 的 384HU 至 400mg I/ml 的 395HU 之间（p=0.079）。剂量长度乘积（p=0.8424）、信噪比（均 p>0.05）、达峰时间（p=0.324）和心率变化（p=0.974）在各组间无差异。峰值压力不同：300mg I/ml 组为 197.4psi（粘度 4.6mPa·s），350mg I/ml 组为 229.8psi（10.4mPa·s），370mg I/ml 组为 216.1psi（9.5mPa·s），400mg I/ml 组为 243.7psi（12.6mPa·s）（p<0.0001）。
当以相同碘输送率注射对比剂时，血管内衰减和心率变化与碘浓度无关。注射压力的差异与对比剂的粘度有关。
当在体温（37°C）下以相同碘输送率注射对比剂时，冠状动脉 CT 血管造影中的对比增强与碘浓度无关。
当以相同碘输送率注射对比剂时，碘浓度不会影响心率变化。
在固定碘输送率和对比剂温度下，对比剂的粘度会影响注射压力。
