Abstract:
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Purpose: To evaluate the safety and effectiveness of gadolinium-enhanced multislice spiral CT angiography of the pulmonary circulation according to the dose administered and the CT technology used.
Methods and Materials: 37 patients with contraindications for the administration of iodinated contrast agents (allergic reactions: n=23; impaired renal function: n=14) underwent a multislice spiral CT examination of the pulmonary circulation with gadolinium (Magnevist, Schering, Germany) indicated in the search for acute pulmonary embolism (n=28) or the management of tumoral disease (n=9). CT angiography was obtained: (a) using a 4- (Group 1; n=19) or 16- (Group 2; n=18) detector-row scanner; (b) at randomly assigned doses of either 0.3 mmol/kg (n=19) or 0.4 mmol/kg (n=18), administered using a power injector at a flow rate of 6 mL/s, followed by a saline flush; (c) with a systematic evaluation of the clinical and biological tolerance of gadolinium. This study was approved by the Ethics Committee and informed consent was obtained from each patient.
Results: The mean (±SD) volume of gadolinium administered in the overall study group was 48 ± 9.6 mL (range: 29-65). The level of maximal (±SD) enhancement within pulmonary arteries in Group 2 was: (a) significantly higher than that observed in Group 1 (216 ± 95 UH vs 141 ± 44UH) (p<0.001); (b) maintained throughout the entire region-of-interest in a greater number of examinations than in Group 1 (n=17; 94% vs n=2; 10%) (p<0.0001). CT angiograms enabled confident analysis of pulmonary arteries down to the segmental and/or subsegmental level in a significantly higher number of patients in Group 2 (n=16; 89%) compared with Group 1 (n=9; 47%) (p<0.01). Significant and transient elevation of creatininemia was observed in only one patient with pre-existing moderate chronic renal failure (dose administered: 0.3 mol/kg).
Conclusion: (1) high-quality gadolinium-enhanced CT angiograms requires the use of the 16-detector row CT technology; (2) the dose of 0.4 mmol/kg did not alter renal function.
Questions about this event email: mremy-jardin@chru-lille.fr
Remy-Jardin MD, PhD, M,
Safety and Effectiveness of Gadolinium-enhanced Multislice Spiral CT Angiography of the Pulmonary Circulation: Preliminary Results in 37 Patients. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3104620.html
