Pop Marian
ME1 Department, "George Emil Palade" University of Medicine Pharmacy Sciences and Technology of Tirgu Mures, 540142 Tirgu Mures, Romania.
Radiology and Medical Imaging Department, Tirgu Mures Emergency Institute for Cardiovascular Diseases and Heart Transplant, 540136 Tirgu Mures, Romania.
Children (Basel). 2021 Oct 21;8(11):949. doi: 10.3390/children8110949.
Computed tomography angiography (CTA) in infants is considered one of the most challenging radiological examinations due to difficulties in balancing start delay, contrast agent (CA) volume and flow in order to achieve optimal opacification of the large vessels. This study aimed to compare the contrast enhancement achieved by four CAs when taking into consideration CA injection parameters and patient characteristics.
We performed a retrospective assessment of forty-eight consecutive cardiothoracic CTAs performed for aortic arch evaluation on children aged 0-1 year. All examinations were performed using the same 64-slice scanner and power injector using the bolus tracking technique. Axial 0.6 mm slices were used to measure large vessel enhancement using regions of interest at the level of the main pulmonary artery, ascending and descending aorta. The recorded variables included anthropometric measurements, CA type, flow rate, volume, and the average Hounsfield unit (HU) values of the blood pool. Descriptive statistics are presented as averages and standard deviations (SD) for normal distributed data or otherwise as medians and interquartile ranges (IQRs).
We found no statistically significant differences between age and anthropometric parameters when looking at different CAs. The median CA volume was 7 (IQR, 7-9) mL with the average flow rate of 0.94 (SD, 0.23) mL/s. Ascending aorta average HU values were 605.9 (SD, 177.23) for Iomeprol 350, 626 (SD, 183.83) for Ioversol 350, 530.83 (SD, 175.56) for Iopromide 370 and 354.91 (SD, 115.81) for Iodixanol 320. The difference in HU value for Iodixanol 320 compared to the other CAs was statistically significant. Similar differences were found for the other vascular structures.
In CTA of infants suspected of aortic arch hypoplasia/coarctation, Iodixanol 320 provided up to 40% less enhancement of the great vessels when compared to Iomeprol 350, Ioversol 350 and Iopromide 370.
由于在平衡启动延迟、造影剂（CA）体积和流速以实现大血管最佳显影方面存在困难，婴儿计算机断层血管造影（CTA）被认为是最具挑战性的放射学检查之一。本研究旨在在考虑造影剂注射参数和患者特征的情况下，比较四种造影剂实现的对比增强效果。
我们对连续48例为评估0至1岁儿童主动脉弓而进行的心胸CTA进行了回顾性评估。所有检查均使用同一台64层扫描仪和高压注射器，并采用团注追踪技术。使用轴向0.6毫米切片，通过在主肺动脉、升主动脉和降主动脉水平的感兴趣区域测量大血管增强情况。记录的变量包括人体测量数据、造影剂类型、流速、体积以及血池的平均亨氏单位（HU）值。对于正态分布的数据，描述性统计以平均值和标准差（SD）表示，否则以中位数和四分位数间距（IQR）表示。
在观察不同造影剂时，我们发现年龄和人体测量参数之间没有统计学上的显著差异。造影剂体积中位数为7（IQR，7 - 9）毫升，平均流速为0.94（SD，0.23）毫升/秒。对于碘普罗胺350，升主动脉平均HU值为605.9（SD，177.23）；对于碘佛醇350，为626（SD，183.83）；对于碘普胺370，为530.83（SD，175.56）；对于碘克沙醇320，为354.91（SD，115.81）。与其他造影剂相比，碘克沙醇320的HU值差异具有统计学意义。在其他血管结构中也发现了类似差异。
在怀疑有主动脉弓发育不全/缩窄的婴儿CTA中，与碘普罗胺350、碘佛醇350和碘普胺370相比，碘克沙醇320使大血管的增强效果降低了多达40%。
