Study of individualized iodine contrast injection protocolin comprehensive multi-region CTA of head-neck-coronary
Objective This study is aimed to explore the feasibility and clinical value of an individualized iodine contrast agent injection protocolin multi body parts CTA of head-neck-coronary by using the third-generation dual-source CT and to compare the heterogeneity of the individualized scheme among different vascular branches.Methods A total of 90 patients who underwent head-neck-coronary CTA were assigned to three groups based on BMI:light weight(BMI ≤ 22 kg/m2,n=30),medium weight(22 kg/m2＜BMI ≤ 26 kg/m2,n=30),and high weight(26 kg/m2＜BMI≤30 kg/m2,n=30).These groups were further equally divided into the individualized group(n=45)and the control group(n=45),with each BMI subgroup containing 15 patients.The individualized group received the individualized protocol,while the control group received 80ml agent at a flow rate of 4.5 ml/s.Subjective assessment,CT val-ue and the reinforcement CV were used to assess the image quality.The CTDIvol,DLP and the ED were obtained.GAM was used to ana-lyze the related factors affecting the image quality of each vascular branch.Results In individualized group,the CT value of all vessels reinforcement were lower than that in the control group(P＜0.001).The arterial enhancement CV of individualized group was smaller than that of the control group.The homogenization of arterial en-hancement in the individualized group is better.The subjective image quality scores were higher than the control group(P＜0.001),and the subjective scores of the two physicians showed good consistency(Kappa=0.769).In light weight group,the differences in CT values of all target vessels between the individualized group and the control group were statistically significant(P＜0.05),the CT val-ues of the individualized group were lower than those of the control group(P＜0.05).In medium weight group,the differences in CT values of all target vessels between the individualized group and the control group were statistically significant(P＜0.05),the CT val-ues of the individualized group were lower than those of the control group(P＜0.05).The number of vessels in the optimal enhancement range(300-450 HU)counts more in individualized group than in the control group(P＜0.05).In light and medium weight subgroups,the CTDIvol,ED,contrast agent amount and velocity of individualized protocol were lower than that by control protocol(P＜0.05).BMI is an important factor affecting artery CT values.After covariate correction,there is still a non-linear relationship between BMI and CT values.Conclusion Head-neck-coronary CTA in multi body parts combined with an individualized contrast agent injection protocol based on BMI using the third-generation dual-source CT can achieve diagnostic requirements and the homogeneity of vascular enhance-ment is better than conventional protocols.
computed tomographyangiographycoronary arteryheadandneckarterybody mass index
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