Background
To explore the feasibility and image quality of ultra-low volume contrast-saline mixture
injection with dual-flow injection technique in a computed tomography angiography
(CTA) protocol in patients scheduled for transcatheter aortic valve implantation (TAVI).
Methods
Forty (40) TAVI candidates underwent investigation with CTA using a third-generation
dual-source CT scanner between September and November 2020. Different volumes of a
monophasic contrast-saline mixture at an 80:20 ratio were administered at an infusion
rate of 3 mL/s in 20 patients (group A). The injected volume was based on patient
body mass index (BMI): 50 mL if BMI <29 kg/m2 and 63 mL if BMI >29 kg/m2. The other 20 patients (group B)—the control cases—received a total of 65 mL of contrast
medium (CM), in multiphasic injections at different flow rates, followed by 10 mL
of saline. The images that were obtained were prospectively evaluated for image quality,
vessel attenuation (HU), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR),
and estimated radiation dose.
Results
Image quality of the aortic root and ilio-femoral vessels was diagnostic in all patients.
Vascular attenuation was >200 HU and CNR >3 at any vessel level.
Conclusions
Data from this study suggest that a monophasic ultra-low volume contrast-saline mixture
injection with a dual-flow technique can provide clear visualisation of the aortic
root and ilio-femoral vessels in pre-TAVI CTA, which is comparable with a standard
multiphasic volume injection protocol.
Keywords
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Article info
Publication history
Published online: February 17, 2023
Accepted:
December 16,
2022
Received in revised form:
December 10,
2022
Received:
February 25,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
