Abstract
BackgroundEnhancement profiles of the pulmonary artery (PA) and aorta differ when using computed tomography (CT) angiography. Our aim was to determine the optimal CT protocol for a one-time CT scan that assesses both blood vessels.MethodsWe prospectively enrolled 101 cases of CT angiography in patients with suspected pulmonary embolism or aortic dissection from our center between 2018 and 2020. We also retrospectively collected the data of 40 patients who underwent traditional two-time CT scans between 2015 and 2018. Patients were divided into four groups: test bolus (TB) I, TB II, bolus-tracking (BT) I, and BT II. The enhancement of the PA and aorta, and the radiation doses used in the four groups were collected. Those who underwent two-time scans were classified into the traditional PA or aorta scan groups. Data were compared between the BT and traditional groups.ResultsThe aortic enhancement was highest in BT II (294.78 ± 64.48 HU) followed BT I (285.18 ± 64.99 HU), TB II (186.58 ± 57.53 HU), and TB I (173.62 ± 69.70 HU). The radiation dose used was lowest in BT I (11.85 ± 5.55 mSv) and BT II (9.07 ± 3.44 mSv) compared with that used in the traditional groups (20.07 ± 7.78 mSv) and accounted for half of the traditional group (45.17–59.02%). The aortic enhancement was also highest in BT II (294.78 ± 64.48 HU) followed by BT I (285.18 ± 64.99 HU) when compared with that in the traditional aorta scan group (234.95 ± 94.18 HU).ConclusionOur CT protocol with a BT technique allows for a lower radiation dose and better image quality of the PA and aorta than those obtained using traditional CT scans.Trial registration: NCT04832633, retrospectively registered in April 2021 to the clinical trial registry.
Highlights
Enhancement profiles of the pulmonary artery (PA) and aorta differ when using computed tomogra‐ phy (CT) angiography
A similar result was noted for radiation dose in the analysis of variance (ANOVA): test bolus (TB) I (8.49 ± 4.18 mSv), TB II (8.65 ± 5.33 mSv), BT I (11.85 ± 5.55 mSv), and BT II (9.07 ± 3.44 mSv) (p = 0.023)
ANOVA showed no significant differences in age, heart rate, systolic and Comparison between the BT and traditional groups Forty patients who underwent two-time CT scans were included in the traditional group
Summary
Enhancement profiles of the pulmonary artery (PA) and aorta differ when using computed tomogra‐ phy (CT) angiography. Demonstration of the coronary arteries is essential, there are many specific requirements for this technique, including a high injection rate (at least 5 mL/s), ECG-gating, and administrationof beta-blockers and sublingual nitroglycerin, and there is a limited scan range from the aortic arch to the base of the heart. This technique can detect the aorta and pulmonary arteries simultaneously, it fails to cover the abdominal aorta and some distal branches of the PA. No study far has presented a one-time CT scan protocol for diagnosing PE and AD simultaneously
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