[Artefact reducing in diagnosis of lung embolism using spiral CT with saline bolus].
OBJECTIVE
To improve the diagnostic efficacy of bolus-enhanced spiral CT (SCT) in the detection of pulmonary embolism using a saline push immediately after bolus injection of the contrast medium.


METHODS
The study included 90 patients with suspected acute or chronic pulmonary embolism. The CT scan was performed in a caudocephaled direction. In Group I (n = 60) we applied a bolus contrast injection (120 ml, 3 ml/s, 300 mg J/ml), after a median delay of 25 s. Group II (n = 30) had the same contrast injection which was immediately followed by an additional saline push (60 ml, 2 ml/s). Streak artifacts originating from high contrast concentrations in the superior vena cava were rated on a 4-point scale for different locations: right pulmonary artery, pars basalis, truncus anterior, and the segmental upper lobe arteries.


RESULTS
The incidence of artifacts in group I was nearly twice as high as in group II. The difference was significant (p < 0.05) for the upper and anterior superior lobe artery, the right pulmonary artery and the pars basalis.


CONCLUSIONS
The presented protocol significantly reduces artifacts mainly by a washout of contrast medium in the superior vena cava.
Vogel
N
N
Klinik und Poliklinik für Radiologie Johannes-Gutenberg-Universität Mainz. Vogel@radiologie.klinik.uni-mainz.de
Kauczor
H U
HU
Heussel
C P
CP
Ries
B G
BG
Thelen
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D003287:Contrast Media; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement; D012965:Sodium Chloride; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; D012965:Sodium Chloride; C038192:iopromide