Thoracic Radiology
Application of low tube voltage combined with low iodine load iso-osmolar contrast in CT angiography for thanscatheter aortic valve replacement planning
Xinshuang Ren, Zhihui Hou, Yang Gao, Weihua Yin, Yitong Yu, Yanan Ma, Bin Lyu
Published 2019-04-10
Cite as Chin J Radiol, 2019, 53(4): 268-273. DOI: 10.3760/cma.j.issn.1005-1201.2019.04.006
Abstract
ObjectiveTo investigate the feasibility, image quality, and safety of low-tube-voltage, low iodine load iso-osmolar contrast comprehensive cardiac and aortoiliac CT angiography (CTA) for transcatheter aortic valve replacement (TAVR) planning.
MethodsNinety-eight consecutive TAVR candidates prospectively underwent combined contrast-enhanced CTA of the aortic root complex and vascular access route. Patients were assigned to group A (2nd generation dual-source CT, 100 kV, contrast 270 mgI/ml iodixanol) or group B (2nd generation dual-source CT, 120 kV, contrast 370 mgI/ml). Mean vascular attenuation, noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of aorta including aortic root, aortic arch, descending aorta at level of diaphragm, abdominal aorta at level of renal artery and femoral artery were compared. Patient creatinine levels before the examination of CTA and during follow-up (24—48 h) were measured.
ResultsThe image quality score of aortic root and whole aorta was (4.2±0.7) and (4.3±0.4) respectively in experimental group, (4.3±0.6) and (4.3±0.3) in control group. No significant difference in subjective image quality score between two groups including aortic root image and whole aorta image (t=-0.130,-0.155,P=0.694, 0.822). The image noise of aortic root and femoral artery were higher in experimental group than that in control group (P<0.05). Radiation dose in experimental group was higher than that in control group [(6.1±0.4) vs. (8.0±0.4) mSv, t=-9.253, P=0.001]. There were no significant changes in creatinine levels among groups during the follow-up.
ConclusionTAVR candidates can be safely and effectively evaluated by a comprehensive CTA protocol with low iodine load iso-osmolar contrast using low-tube-voltage acquisition.
Key words:
Thanscatheter aortic valve replacement; Tomography, X-ray computed; Iso-osomolar contrast; Low tube voltage
Contributor Information
Xinshuang Ren
Department of Radiology, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
Zhihui Hou
Yang Gao
Weihua Yin
Yitong Yu
Yanan Ma
Bin Lyu