title: Eighty-peak kilovoltage 16-channel multidetector computed tomography and reduced contrast-medium doses tailored to body weight to diagnose pulmonary embolism in azotaemic patients.
abstract: The aim of this study was to assess the feasibility of minimising contrast-medium (CM) doses using 80-peak kilovoltage (kVp) 16-channel multidetector computed tomography (MDCT) with CM dose tailored to body weight, when diagnosing pulmonary embolism (PE) in azotaemic patients. Twenty-nine patients (68-93 years; 38-79 kg) with an estimated glomerular filtration rate of 12-49 ml/min underwent 80 kVp MDCT at a median dose of 200 mg iodine (I)/kg and 15 s injection time. Pulmonary artery (PA) enhancement where compared with our own reference material using 320 mg I/kg at 120 kVp and with reported figures in the literature at 120-140 kVp and a 42 g iodine CM dose. Median (1st and 3rd quartiles) values regarding CM dose were 12.2 (9.9-12.8) g iodine; density of left main and lower lobe segmental PA 339 (275-395) Hounsfield units (HU) and 354 (321-442) HU, respectively. Those enhancement values were similar to those obtained from the reference population at 120 kVp and those reported in the literature at 120-140 kVp. One patient had a transient increase in plasma creatinine. Three months' follow-up revealed deep venous thrombosis among 1/18 patients with negative results from computed tomography (CT). We conclude that 80 kVp 16-channel MDCT to diagnose PE in azotaemic patients may be performed with markedly reduced CM doses, implying a lesser risk for CM-induced nephropathy.
authors.affiliation: Department of Radiology, Malmö University Hospital, Lund University, 205 02 Malmö, Sweden. fholmquist@yahoo.com
authors.forename: Fredrik
authors.initials: F
authors.lastname: Holmquist
authors.forename: Ulf
authors.initials: U
authors.lastname: Nyman
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D053099:Azotemia / Q000000981:diagnostic imaging* / Q000378:metabolism; D001835:Body Weight; D002302:Cardiac Output / Q000187:drug effects; D003287:Contrast Media / Q000008:administration & dosage* / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007455:Iodine / Q000008:administration & dosage / Q000378:metabolism; D007668:Kidney / Q000187:drug effects / Q000378:metabolism; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000187:drug effects; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000378:metabolism; D011829:Radiation Dosage; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted; D014057:Tomography, X-Ray Computed; D014131:Trace Elements / Q000008:administration & dosage / Q000378:metabolism
chemical_list: D003287:Contrast Media; D014131:Trace Elements; D007455:Iodine; D003404:Creatinine