Bodyweight-adjusted Contrast Media With Shortened Injection Duration for Step-and-Shoot Coronary Computed Tomography Angiography to Acquire Improved Image Quality.

Abstract

Shortened injection durations are not recommended in step-and-shoot coronary computed tomography angiography (CCTA). We aimed to evaluate the image quality of CCTA performed using bodyweight-adjusted iodinated contrast media (ICM) with different injection durations to generate an optimized ICM administration protocol to acquire convincible image quality in step-and-shoot CCTA. A total of 200 consecutive patients with suspected coronary artery disease (CAD) were enrolled in group A (N=50, 350mgI/mL, bodyweight×0.8mL/kg with a 13-s injection duration), group B (N=50, 350mgI/mL, bodyweight×0.9mL/kg with a 13-s injection duration), group C (N=50, 350mgI/mL, bodyweight×0.8mL/kg with a 12-s injection duration), and group D (N=50, 320mgI/mL, bodyweight×0.8mL/kg with a 13-s injection duration). Patient characteristics, ICM administration protocols, quantitative computed tomography (CT) value measurements, and qualitative image scores were analyzed and compared among the groups. Groups A and D achieved the lowest ICM volume, saline volume, injection flow rate, and total iodine and iodine injection rates among the groups. All the CT values of the coronary arteries in all groups were >300HU. All the observers' average scores exceeded three points. In group A, the CT values showed significant positive correlation with the iodine injection rate ( r =0.226, P <0.001), whereas the signal-to-noise ratio ( r =-0.004, P =0.927) and contrast-to-noise ratio ( r =-0.006, P =0.893) values were not. Bodyweight×0.8mL/kg with a 13-second injection duration is a comprehensive option for step-and-shoot CCTA with improved image quality, and a 350mgI/mL iodine concentration is preferred.