Pulmonary CT angiography protocol adapted to the hemodynamic effects of pregnancy.

Hdl Handle:
http://hdl.handle.net/10147/207695
Title:
Pulmonary CT angiography protocol adapted to the hemodynamic effects of pregnancy.
Authors:
Ridge, Carole A; Mhuircheartaigh, Jennifer N; Dodd, Jonathan D; Skehan, Stephen J
Affiliation:
Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland.
Citation:
AJR Am J Roentgenol. 2011 Nov;197(5):1058-63.
Journal:
AJR. American journal of roentgenology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207695
DOI:
10.2214/AJR.10.5385
PubMed ID:
22021496
Abstract:
OBJECTIVE: The purpose of this study was to compare the image quality of a standard pulmonary CT angiography (CTA) protocol with a pulmonary CTA protocol optimized for use in pregnant patients with suspected pulmonary embolism (PE). MATERIALS AND METHODS: Forty-five consecutive pregnant patients with suspected PE were retrospectively included in the study: 25 patients (group A) underwent standard-protocol pulmonary CTA and 20 patients (group B) were imaged using a protocol modified for pregnancy. The modified protocol used a shallow inspiration breath-hold and a high concentration, high rate of injection, and high volume of contrast material. Objective image quality and subjective image quality were evaluated by measuring pulmonary arterial enhancement, determining whether there was transient interruption of the contrast bolus by unopacified blood from the inferior vena cava (IVC), and assessing diagnostic adequacy. RESULTS: Objective and subjective image quality were significantly better for group B-that is, for the group who underwent the CTA protocol optimized for pregnancy. Mean pulmonary arterial enhancement and the percentage of studies characterized as adequate for diagnosis were higher in group B than in group A: 321 +/- 148 HU (SD) versus 178 +/- 67 HU (p = 0.0001) and 90% versus 64% (p = 0.05), respectively. Transient interruption of contrast material by unopacified blood from the IVC was observed more frequently in group A (39%) than in group B (10%) (p = 0.05). CONCLUSION: A pulmonary CTA protocol optimized for pregnancy significantly improved image quality by increasing pulmonary arterial opacification, improving diagnostic adequacy, and decreasing transient interruption of the contrast bolus by unopacified blood from the IVC.
Language:
eng
MeSH:
Adult; Angiography/*methods; Artifacts; Chi-Square Distribution; *Clinical Protocols; Contrast Media/diagnostic use; Female; Hemodynamics; Humans; Pregnancy; Pregnancy Complications, Cardiovascular/*radiography; Pulmonary Embolism/*radiography; Retrospective Studies; Tomography, X-Ray Computed/*methods
ISSN:
1546-3141 (Electronic); 0361-803X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorRidge, Carole Aen_GB
dc.contributor.authorMhuircheartaigh, Jennifer Nen_GB
dc.contributor.authorDodd, Jonathan Den_GB
dc.contributor.authorSkehan, Stephen Jen_GB
dc.date.accessioned2012-02-01T10:35:11Z-
dc.date.available2012-02-01T10:35:11Z-
dc.date.issued2012-02-01T10:35:11Z-
dc.identifier.citationAJR Am J Roentgenol. 2011 Nov;197(5):1058-63.en_GB
dc.identifier.issn1546-3141 (Electronic)en_GB
dc.identifier.issn0361-803X (Linking)en_GB
dc.identifier.pmid22021496en_GB
dc.identifier.doi10.2214/AJR.10.5385en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207695-
dc.description.abstractOBJECTIVE: The purpose of this study was to compare the image quality of a standard pulmonary CT angiography (CTA) protocol with a pulmonary CTA protocol optimized for use in pregnant patients with suspected pulmonary embolism (PE). MATERIALS AND METHODS: Forty-five consecutive pregnant patients with suspected PE were retrospectively included in the study: 25 patients (group A) underwent standard-protocol pulmonary CTA and 20 patients (group B) were imaged using a protocol modified for pregnancy. The modified protocol used a shallow inspiration breath-hold and a high concentration, high rate of injection, and high volume of contrast material. Objective image quality and subjective image quality were evaluated by measuring pulmonary arterial enhancement, determining whether there was transient interruption of the contrast bolus by unopacified blood from the inferior vena cava (IVC), and assessing diagnostic adequacy. RESULTS: Objective and subjective image quality were significantly better for group B-that is, for the group who underwent the CTA protocol optimized for pregnancy. Mean pulmonary arterial enhancement and the percentage of studies characterized as adequate for diagnosis were higher in group B than in group A: 321 +/- 148 HU (SD) versus 178 +/- 67 HU (p = 0.0001) and 90% versus 64% (p = 0.05), respectively. Transient interruption of contrast material by unopacified blood from the IVC was observed more frequently in group A (39%) than in group B (10%) (p = 0.05). CONCLUSION: A pulmonary CTA protocol optimized for pregnancy significantly improved image quality by increasing pulmonary arterial opacification, improving diagnostic adequacy, and decreasing transient interruption of the contrast bolus by unopacified blood from the IVC.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAngiography/*methodsen_GB
dc.subject.meshArtifactsen_GB
dc.subject.meshChi-Square Distributionen_GB
dc.subject.mesh*Clinical Protocolsen_GB
dc.subject.meshContrast Media/diagnostic useen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHemodynamicsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshPregnancyen_GB
dc.subject.meshPregnancy Complications, Cardiovascular/*radiographyen_GB
dc.subject.meshPulmonary Embolism/*radiographyen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshTomography, X-Ray Computed/*methodsen_GB
dc.titlePulmonary CT angiography protocol adapted to the hemodynamic effects of pregnancy.en_GB
dc.contributor.departmentDepartment of Radiology, St. Vincent's University Hospital, Dublin, Ireland.en_GB
dc.identifier.journalAJR. American journal of roentgenologyen_GB
dc.description.provinceLeinster-

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