title: Catheter contrast-enhanced coronary CT-angiography using an aortic root injection--preliminary technical development in four patients.
abstract: The feasibility of performing coronary computed tomographic angiography (CTA) with an intra-aortic injection of iodinated contrast was tested in four patients immediately following diagnostic cardiac catheterization and placement of a 6-french pigtail catheter into the aortic root. A diluted contrast mixture [75 cc Omnipaque 350 mixed with 125 cc normal saline (4-slice scanner) vs. 40 cc Omnipaque 350 mixed with 60 cc normal saline (16-slice scanner)] was injected at a rate of 6 to 7.7 cc/sec at the onset of breath-hold and helical (4 slice, n=3, and 16-slice, n=1) retrospective ECG-triggered acquisition. The proximal and distal coronary vasculature including small tributaries were depicted with high signal-to-noise (S/N) and free from underlying blood pool enhancement. The right coronary artery was sub optimally enhanced in two patients. No significant disease was found on CTA or XRA in two patients; however, severe multivessel disease was demonstrated on both modalities in two patients. Catheter contrast-enhanced coronary CTA is feasible utilizing low injection rates and low iodinated contrast volumes, however, catheter modifications are required for consistent and homogeneous opacification of the aortic root.
authors.affiliation: Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA. kbis@beaumont.edu
authors.forename: Kostaki G
authors.initials: KG
authors.lastname: Bis
authors.forename: Anil N
authors.initials: AN
authors.lastname: Shetty
authors.forename: Stacey
authors.initials: S
authors.lastname: Brewington
authors.forename: William
authors.initials: W
authors.lastname: O'Neill
mesh_terms: D001011:Aorta; D006328:Cardiac Catheterization; D003287:Contrast Media / Q000008:administration & dosage*; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007269:Injections, Intra-Arterial; D007472:Iohexol / Q000008:administration & dosage; D011856:Radiographic Image Enhancement / Q000379:methods; D036542:Tomography, Spiral Computed / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol