Dynamic Coronary 320-Row CT Angiography Using Low-Dose Contrast and Temporal Maximum Intensity Projection: A Comparison with Standard Coronary CT Angiography

다국어 초록 (Multilingual Abstract)

Objective: The smallest diagnostically sufficient amount of contrast media (CM) should be used for coronary computed tomography angiography (CCTA) to minimize the risk of contrast- induced nephrotoxicity in elderly patients with coronary artery disease. The purpose of this study was to propose dynamic-CCTA using a low dose of CM and temporal maximum intensity projection (TMIP) and to investigate its image quality compared to standard-CCTA.
Materials and Methods: Participants comprised 30 patients with coronary artery disease who underwent dynamic-CCTA and standard-CCTA using 320-row CT. Dynamic-CCTA was continuously performed at mid-diastole throughout 15–25 cardiac cycles after bolus injection of CM [103 mg iodine/kg body weight (mgI/kg)]. TMIP-CCTA was reconstructed from three-phase dynamic-CCTA data, including a phase with peak enhancement of the ascending aorta. Standard-CCTA was performed using a standard CM dose (259 mgI/kg). Image quality of both TMIP-CCTA and standard-CCTA was analyzed.
Results: The amount of CM used in TMIP-CCTA and standard-CCTA was 16.2±2.6 mL and 40.1±7.3 mL, respectively. The mean effective radiation dose was not significantly different between the two methods. Mean coronary attenuation was significantly lower for TMIP-CCTA than standard-CCTA [346.9±82.8 Hounsfield units (HU) vs. 455.4±75.3 HU, p<0.05]. Image noise was significantly lower for TMIP-CCTA than standard-CCTA (20.0±3.2 HU vs. 28.1± 3.6 HU, p<0.05). There were no differences in signal-to-noise ratio and visual assessment scores between the two methods.
Conclusion: TMIP-CCTA can be performed using more than 50% less CM with the same image quality as standard-CCTA.