Waiting to exhale: salvaging the nondiagnostic CT pulmonary angiogram by using expiratory imaging to improve contrast dynamics

Emergency Radiology
Yung Hsin ChenThinh H Vu

Abstract

We attempted to investigate whether computed tomography pulmonary angiography (CTPA) in the expiratory phase can improve contrast enhancement of the pulmonary arteries and mitigate the effect of inspiratory transient attenuation artifact, potentially salvaging nondiagnostic studies. Eighteen patients with indeterminate inspiratory CTPA, despite proper contrast bolus were studied. Patients were rescanned in expiration using the same contrast bolus and scanning parameters. The attenuation of each pulmonary arterial segment, superior and inferior vena cava, and atria and ventricles during the two phases of respiration was measured independently by three radiologists. All pulmonary segments were evaluated for filling defects during the two phases. In addition, the studies were graded for diagnostic quality of enhancement and probable impact on management. A statistically significant increase in pulmonary arterial enhancement was seen during expiration from the pulmonary trunk to the segmental pulmonary arteries (P < 0.001) and for the inferior vena cava, the right atrium, and the ventricle. The incidence of nondiagnostic inspiratory studies ranged from 89 to 100%, depending on the observer. All studies were upgraded to fully accept...Continue Reading

References

Feb 1, 1992·Journal of Applied Physiology·M Takata, J L Robotham
May 17, 1992·The New England Journal of Medicine·J L CarsonT E Hobbins
Apr 1, 1987·Australian and New Zealand Journal of Medicine·F A KhafagiI R Gough
Jan 1, 1987·Vox Sanguinis·P Y Le PennecC Salmon
Oct 8, 1998·AJR. American Journal of Roentgenology·M E TublinF N Tessler
Sep 9, 1999·Radiology·M Remy-Jardin, J Remy
Jan 9, 2004·Journal of Thoracic Imaging·Marc V GosselinAllison Oki
May 12, 2004·The American Journal of Cardiology·Paul D SteinRonald E Olson
Jul 13, 2004·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Antonia Carla TestaGabriella Ferrandina
Sep 17, 2004·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Conrad WittramTheresa C McLoud
Nov 18, 2004·AJR. American Journal of Roentgenology·Tadhg G Gleeson, Sudi Bulugahapitiya
Mar 1, 2005·Radiology·Lawrence R Goodman

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Citations

Oct 22, 2009·AJR. American Journal of Roentgenology·Carole A RidgeStephen J Skehan
Feb 24, 2011·AJR. American Journal of Roentgenology·Markus WeiningerU Joseph Schoepf
Aug 13, 2017·Emergency Radiology·Jeff JensenPamela T Johnson
Mar 10, 2016·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Paul G Thacker, Edward Y Lee
Apr 11, 2012·Journal of Thoracic Imaging·Ralf W BauerJosef Matthias Kerl

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