Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany.
Siemens Healthcare GmbH, Research and Development, Forchheim, Germany.
Int J Cardiovasc Imaging. 2020 Oct;36(10):2051-2059. doi: 10.1007/s10554-020-01911-8. Epub 2020 Jun 6.
To compare intravenous contrast material (CM) injection protocols for dual-energy CT pulmonary angiography (CTPA) in patients with suspected acute pulmonary embolism with regard to image quality and pulmonary perfused blood volume (PBV) values. A total of 198 studies performed with four CM injection protocols varying in CM volume and iodine delivery rates (IDR) were retrospectively included: (A) 60 ml at 5 ml/s (IDR = 1.75gI/s), (B) 50 ml at 5 ml/s (IDR = 1.75gI/s), (C) 50 ml at 4 ml/s (IDR = 1.40gI/s), (D) 40 ml at 3 ml/s (IDR = 1.05gI/s). Image quality and PBV values at different resolution settings were compared. Pulmonary arterial tract attenuation was highest for protocol A (397 ± 110 HU; p vs. B = 0.13; vs. C = 0.02; vs. D < 0.001). CTPA image quality of protocol A was rated superior compared to protocols B and D by reader 1 (p = 0.01; < 0.001), and superior to protocols B, C and D by reader 2 (p < 0.001; 0.02; < 0.001). Otherwise, there were no significant differences in CTPA quality ratings. Subjective iodine map ratings did not vary significantly between protocols A, B, and C. Both readers rated protocol D inferior to all other protocols (p < 0.05). PBV values did not vary significantly between protocols A and B at resolution settings of 1, 4 and 10 (p = 0.10; 0.10; 0.09), while otherwise PBV values displayed a decreasing trend from protocol A to D (p < 0.05). Higher CM volume and IDR are associated with superior CTPA and iodine map quality and higher absolute PBV values.
比较四种不同对比剂注射方案（CM 量和碘输送率（IDR）不同）在疑似急性肺栓塞患者的双能 CT 肺动脉造影（CTPA）中的应用，以评估图像质量和肺灌注血容量（PBV）值。共回顾性纳入 198 例采用四种 CM 注射方案（A：60ml 以 5ml/s 注射，IDR=1.75gI/s；B：50ml 以 5ml/s 注射，IDR=1.75gI/s；C：50ml 以 4ml/s 注射，IDR=1.40gI/s；D：40ml 以 3ml/s 注射，IDR=1.05gI/s）的 CTPA 研究。比较不同空间分辨率下的图像质量和 PBV 值。方案 A 的肺动脉管腔衰减最高（397±110 HU；p 与 B 相比=0.13；与 C 相比=0.02；与 D 相比<0.001）。读者 1 认为方案 A 的 CTPA 图像质量优于方案 B 和 D（p=0.01；<0.001），读者 2 认为方案 A 的 CTPA 图像质量优于方案 B、C 和 D（p<0.001；0.02；<0.001）。否则，CTPA 质量评分无显著差异。主观碘图评分在方案 A、B 和 C 之间无显著差异。两位读者均认为方案 D 劣于其他所有方案（p<0.05）。在 1、4 和 10 的分辨率设置下，方案 A 和 B 的 PBV 值无显著差异（p=0.10；0.10；0.09），而方案 A 到 D 的 PBV 值呈下降趋势（p<0.05）。更高的 CM 量和 IDR 与更高的 CTPA 和碘图质量以及更高的绝对 PBV 值相关。
