Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA.
Clin Imaging. 2022 Feb;82:15-20. doi: 10.1016/j.clinimag.2021.10.011. Epub 2021 Nov 3.
Concerns about potential risks of using contrast media in patients with chronic renal insufficiency limit the utilization of CT angiography in this population.
To evaluate the feasibility of abdominopelvic CTA with very low volumes of contrast media.
In this retrospective study, 20 patients with chronic renal insufficiency underwent high-pitch abdominopelvic (AP) CTA on a third-generation dual-source CT scanner with 30 mL of nonionic iodinated contrast. The homogeneity of intravascular attenuation at the suprarenal aorta, infrarenal aorta, and the right common iliac artery was measured. Image noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were used to assess objective image quality. Subjective image quality was evaluated on a 5-point scale (1 = unacceptable; 5 = excellent).
Twelve male and eight female patients underwent CTA of the abdomen and pelvis at 80 kVp. Five CTAs also included the chest (CAP). The mean scan duration was 0.78 ± 0.19 s for AP and 0.96 ± 0.06 s for CAP CTAs. The mean ± SD of attenuation at suprarenal aorta, infrarenal aorta, and right common iliac artery were 235.1 ± 68.0, 249.2 ± 61.3, and 254.4 ± 67.7 HU, respectively. The attenuation was homogeneous across vascular levels (P = 0.06). All scans had diagnostic subjective image quality with the median (IQR) of 3.5 (1.75). CNR and SNR were homogeneous across vascular levels (P = 0.08 and P = 0.14, respectively).
Sub-second, high-pitch abdominopelvic CTA with a low volume of contrast in patients with chronic renal insufficiency is technically and clinically feasible with good diagnostic image quality and homogenous attenuation across vascular levels.
由于对慢性肾功能不全患者使用造影剂的潜在风险的担忧，限制了 CT 血管造影在该人群中的应用。
评估使用极低剂量造影剂行腹部盆腔 CT 血管造影（CTA）的可行性。
本回顾性研究纳入了 20 例慢性肾功能不全患者，在第三代双源 CT 扫描仪上行高心率腹部盆腔（AP）CTA，使用 30ml 非离子型碘造影剂。测量肾上主动脉、肾下主动脉和右髂总动脉的血管内衰减均匀性。使用图像噪声、对比噪声比（CNR）和信噪比（SNR）评估客观图像质量。主观图像质量采用 5 分制（1 分为不可接受，5 分为极好）进行评估。
12 例男性和 8 例女性患者行腹部和盆腔 CTA，5 例 CTA 还包括胸部（CAP）。AP 和 CAP CTA 的平均扫描时间分别为 0.78±0.19s 和 0.96±0.06s。肾上主动脉、肾下主动脉和右髂总动脉的平均±标准差分别为 235.1±68.0、249.2±61.3 和 254.4±67.7HU。血管水平的衰减均匀（P=0.06）。所有扫描均具有诊断性的主观图像质量，中位数（IQR）为 3.5（1.75）。CNR 和 SNR 在血管水平上均匀（P=0.08 和 P=0.14）。
对于慢性肾功能不全患者，采用次秒级、高心率、低剂量造影剂的腹部盆腔 CTA 在技术和临床方面是可行的，具有良好的诊断图像质量和血管水平的均匀衰减。
