Pulmonary CT angiography protocol adapted to the hemodynamic effects of pregnancy.
Affiliation
Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland.Issue Date
2012-02-01T10:35:11ZMeSH
AdultAngiography/*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
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AJR Am J Roentgenol. 2011 Nov;197(5):1058-63.Journal
AJR. American journal of roentgenologyDOI
10.2214/AJR.10.5385PubMed ID
22021496Abstract
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
engISSN
1546-3141 (Electronic)0361-803X (Linking)
ae974a485f413a2113503eed53cd6c53
10.2214/AJR.10.5385
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