Impact of rapid iodine contrast agent infusion on tracheal diameter and lung volume in CT pulmonary angiography measured with deep learning-based algorithm.

Abstract

To compare computed tomography (CT) pulmonary angiography and unenhanced CT to determine the effect of rapid iodine contrast agent infusion on tracheal diameter and lung volume. This retrospective study included 101 patients who underwent CT pulmonary angiography and unenhanced CT, for which the time interval between them was within 365 days. CT pulmonary angiography was scanned 20 s after starting the contrast agent injection at the end-inspiratory level. Commercial software, which was developed based on deep learning technique, was used to segment the lung, and its volume was automatically evaluated. The tracheal diameter at the thoracic inlet level was also measured. Then, the ratios for the CT pulmonary angiography to unenhanced CT of the tracheal diameter (TDPAU) and both lung volumes (BLVPAU) were calculated. Tracheal diameter and both lung volumes were significantly smaller in CT pulmonary angiography (17.2 ± 2.6mm and 3668 ± 1068ml, respectively) than those in unenhanced CT (17.7 ± 2.5mm and 3887 ± 1086ml, respectively) (p < 0.001 for both). A statistically significant correlation was found between TDPAU and BLVPAU with a correlation coefficient of 0.451 (95% confidence interval, 0.280-0.594) (p < 0.001). No factor showed a significant association with TDPAU. The type of contrast agent had a significant association for BLVPAU (p = 0.042). Rapid infusion of iodine contrast agent reduced the tracheal diameter and both lung volumes in CT pulmonary angiography, which was scanned at end-inspiratory level, compared with those in unenhanced CT.