Radiology Department, Huadong Hospital, Affiliated with Fudan University.
Shanghai Changfeng Community Health Service Center.
J Thorac Imaging. 2024 May 1;39(3):146-156. doi: 10.1097/RTI.0000000000000696. Epub 2023 Jan 23.
Shortened injection durations are not recommended in step-and-shoot coronary computed tomography angiography (CCTA). We aimed to evaluate the image quality of CCTA performed using bodyweight-adjusted iodinated contrast media (ICM) with different injection durations to generate an optimized ICM administration protocol to acquire convincible image quality in step-and-shoot CCTA.
A total of 200 consecutive patients with suspected coronary artery disease (CAD) were enrolled in group A (N=50, 350 mgI/mL, bodyweight×0.8 mL/kg with a 13-s injection duration), group B (N=50, 350 mgI/mL, bodyweight×0.9 mL/kg with a 13-s injection duration), group C (N=50, 350 mgI/mL, bodyweight×0.8 mL/kg with a 12-s injection duration), and group D (N=50, 320 mgI/mL, bodyweight×0.8 mL/kg with a 13-s injection duration). Patient characteristics, ICM administration protocols, quantitative computed tomography (CT) value measurements, and qualitative image scores were analyzed and compared among the groups.
Groups A and D achieved the lowest ICM volume, saline volume, injection flow rate, and total iodine and iodine injection rates among the groups. All the CT values of the coronary arteries in all groups were >300 HU. All the observers' average scores exceeded three points. In group A, the CT values showed significant positive correlation with the iodine injection rate ( r =0.226, P <0.001), whereas the signal-to-noise ratio ( r =-0.004, P =0.927) and contrast-to-noise ratio ( r =-0.006, P =0.893) values were not.
Bodyweight×0.8 mL/kg with a 13-second injection duration is a comprehensive option for step-and-shoot CCTA with improved image quality, and a 350 mgI/mL iodine concentration is preferred.
在步进式冠状动脉计算机断层扫描血管造影术（CCTA）中，不建议缩短注射时间。我们旨在评估使用体重调整碘造影剂（ICM）进行 CCTA 的图像质量，以不同的注射时间生成优化的 ICM 给药方案，以在步进式 CCTA 中获得令人信服的图像质量。
共纳入 200 例疑似冠心病（CAD）患者，分为 A 组（N=50，350mgI/mL，体重×0.8mL/kg，注射时间 13 秒）、B 组（N=50，350mgI/mL，体重×0.9mL/kg，注射时间 13 秒）、C 组（N=50，350mgI/mL，体重×0.8mL/kg，注射时间 12 秒）和 D 组（N=50，320mgI/mL，体重×0.8mL/kg，注射时间 13 秒）。分析比较了各组患者的一般特征、ICM 给药方案、定量 CT 值测量和定性图像评分。
A 组和 D 组的 ICM 容积、生理盐水容积、注射流率、总碘量和碘注射率均为最低。所有组的冠状动脉 CT 值均>300HU。所有观察者的平均评分均超过 3 分。在 A 组中，CT 值与碘注射率呈显著正相关（r=0.226，P<0.001），而信噪比（r=-0.004，P=0.927）和对比噪声比（r=-0.006，P=0.893）值无相关性。
体重×0.8mL/kg，注射时间 13 秒是一种综合选择，可改善步进式 CCTA 的图像质量，碘浓度 350mgI/mL 为首选。
